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This form is used for collecting information about a patient's medical admission.
Healthcare providers and medical facilities are required to file this form.
The form can be filled out electronically or manually with information about the patient's admission.
The purpose of this form is to gather data on in-patient medical admissions for record-keeping and statistical analysis.
Information such as patient demographics, admission date, discharge date, diagnosis, procedures, and outcomes must be reported on this form.
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