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Patient Registration Please print clearly Name Mr / Mrs / Dr / Ms / Miss : Date of birth: Social Security # Address: zip Cell Phone Home # Work # Personal Primary Physician: Physician who is an if
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A prefix used before a person's name to denote their gender or professional title, such as Mr. for men, Mrs. for married women, and Dr. for doctors.
Individuals or entities required to use these prefixes according to social or professional norms.
Simply include the appropriate prefix before the person's name in formal or professional settings.
To denote the gender or professional title of the person being referred to in a respectful manner.
Only the appropriate prefix before the person's name is required to be reported.
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