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Name Age Ht Wt Reason For Today's Visit Date of Injury/Onset Where Are You Working Now? Y N Date Last Worked Occupation How Did This Happen? ALLERGIES:(Please indicate your reaction to the right of
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How to fill out name age ht wt
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To fill out name: Write your full name in the designated field.
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To fill out age: Write your current age in years.
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To fill out height (ht): Write your height in either feet and inches or centimeters.
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To fill out weight (wt): Write your weight in either pounds or kilograms.
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What is name age ht wt?
Name age ht wt refers to the basic personal information about an individual, including their name, age, height, and weight.
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The purpose of requesting name age ht wt is to gather basic information about an individual for identification or record-keeping purposes.
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On name age ht wt, you must provide accurate and up-to-date information about your name, age, height, and weight.
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