Get the free DOB ( ) STAT Patient Social Security # MR#/Alternate Pt ID ...
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IU Health System Pathology Laboratories
350 W. 11th Street, Room 5013
Indianapolis, IN 462024108
317.491.6000 or 800.433.0740
Fax: 317.491.6001
1) Patient Legal Name (Last, First M I)Embrace R# /A
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How to fill out dob stat patient social
How to fill out dob stat patient social
01
To fill out dob stat patient social, follow these steps:
02
Begin with the patient's Date of Birth (DOB).
03
Enter the patient's current marital status.
04
Enter the patient's Social Security Number (SSN).
05
If the patient does not have a SSN, leave the field blank.
06
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Healthcare providers and medical institutions need dob stat patient social.
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What is dob stat patient social?
dob stat patient social is a form that collects the social and demographic information of patients.
Who is required to file dob stat patient social?
Healthcare providers and facilities are required to file dob stat patient social.
How to fill out dob stat patient social?
dob stat patient social can be filled out online or manually by providing the required information of the patient.
What is the purpose of dob stat patient social?
The purpose of dob stat patient social is to gather data on patients' social and demographic characteristics for statistical analysis and healthcare planning.
What information must be reported on dob stat patient social?
Information such as patient's age, gender, race, ethnicity, and income level must be reported on dob stat patient social.
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