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MEDICAL HISTORY NAME: WEIGHT:HEIGHT:BIRTHDATE:IF SO, WHO?ARE YOU CURRENTLY BEING TREATED BY A PHYSICIAN? PHYSICIAN:PHONE #:Dr. ADDRESS:RESULTS/FINDINGS:DATE OF LAST EXAM: WHAT IS YOUR ESTIMATION OF
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Forms primary health medical is a document used to report information about an individual's primary health coverage.
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The purpose of forms primary health medical is to provide the IRS with information about an individual's primary health coverage for tax purposes.
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