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TIME 03:57 DATE 6/26/2014PATIENT REGISTRATION
ID:Chart ID:First Name:
Patient Is:Last Name:
Policy HolderResponsible PartyMiddle Initial:Preferred Name:Responsible Party (if someone other than the
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Write '57' to represent the minutes (3:57)
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Time 0357 pm refers to a specific time designation, which is 3:57 PM.
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