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Today's Date: PATIENT HISTORY FORM Patient Name: SS #: Date of Birth: Primary Care Physician: Optometrist: Ophthalmologist: Cardiologist: Endocrinologist: Pharmacy 1: Pharmacy Location: Pharmacy Phone
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MI - Shady Grove is a tax form used in Michigan for reporting certain income and tax information.
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MI - Shady Grove requires reporting of total income, deductions, credits, and any other relevant tax information pertinent to the taxpayer's situation.
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