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PATIENT REGISTRATION # (PLEASE PRINT)1. PATIENT INFORMATION PATIENTS LEGAL NAME: DATE OF BIRTH: RACE:White ETHNICITY:African American Hispanic SEX: Asian American Indian Native Hawaiian All Other
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How to fill out if yes retirement date
01
To fill out if yes retirement date, follow these steps:
02
Start by entering your personal information such as name, address, and contact details in the appropriate fields.
03
Look for the section that asks about your retirement plans and select 'Yes' to indicate that you have a retirement date.
04
Provide the specific retirement date in the designated field. Make sure to input the correct date format.
05
Double-check all the information you entered to ensure accuracy and completeness.
06
Once you have filled out all the necessary fields, review the form one last time and click 'Submit' to finalize your submission.
Who needs if yes retirement date?
01
If you have a retirement date planned and want to inform relevant parties or organizations, you should fill out the retirement date section. This can include employers, pension providers, HR departments, or any other entities that require notification of your retirement plans.
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