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MultnomahCountyAnimalServices 1020NWCorporateDr. Trout dale,OR97060 (Mailing only) P5039887387F5039883444ANIMALBITEREPORT NameofHospital/Clinic: DateandApproximateTimeofBite: NameofVictim: Address:
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What is nameofhospitalclinic?
Name of Hospital/Clinic refers to the official title of a medical facility providing healthcare services.
Who is required to file nameofhospitalclinic?
Healthcare providers and organizations operating hospitals or clinics must file the name of the hospital/clinic.
How to fill out nameofhospitalclinic?
To fill out the name of the hospital/clinic, one should enter the official registered name as it appears on legal documents.
What is the purpose of nameofhospitalclinic?
The purpose of the name of the hospital/clinic is to identify the legal entity responsible for providing healthcare services.
What information must be reported on nameofhospitalclinic?
Information that must be reported includes the legal name, address, and type of services offered by the hospital or clinic.
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