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This certificate hereby certifies that has successfully completed Pediatric Disaster Triage Utilizing the Jump start Method Provider Course DATE: DPH Site Code: 3 Hours of didactic continuing education
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Start by entering the date in the designated space.
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Provide the name and contact information of the person or organization certifying the document.
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State the purpose of the certification in a clear and concise manner.
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List any supporting documents or evidence that accompany the certification.
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Sign and date the certification, and include any necessary seal or stamp.
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Make copies of the completed certification for your own records, if needed.

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Hereby certifies that is a statement declaring the accuracy and truth of the information provided.
Any individual or entity who needs to affirm the accuracy of the information being submitted.
The individual or entity must complete the statement and sign it to affirm its accuracy.
The purpose of hereby certifies that is to ensure that the information provided is accurate and truthful.
The information that must be reported will depend on the specific document or form being filed.
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