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PATIENT DEMOGRAPHICS Version 09.24.2015 NAME(Please Circle One)MR. MRS. MS. DR.FIRST: MI: DATE: LAST: DATE OF BIRTH: GENDER: NICKNAME: ,,,
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What is patient demographics version 0924?
Patient demographics version 0924 is a standardized form used to collect information about a patient's personal and medical details.
Who is required to file patient demographics version 0924?
Healthcare providers and facilities are required to file patient demographics version 0924 for each patient they see.
How to fill out patient demographics version 0924?
Patient demographics version 0924 can be filled out by entering the patient's name, address, contact information, insurance details, and medical history into the designated fields.
What is the purpose of patient demographics version 0924?
The purpose of patient demographics version 0924 is to gather accurate and up-to-date information about patients to ensure proper treatment and care.
What information must be reported on patient demographics version 0924?
Patient demographics version 0924 must include the patient's name, date of birth, gender, contact information, insurance details, medical history, and any other relevant information.
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