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PRINTED: DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES(X1) PROVIDER/SUPPLIER/LIGAND PLAN OF CORRECTIONIDENTIFICATION NUMBER:15010405/25/2012FORM
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S0000 is a form used for reporting visit information.
Anyone who conducted the visit is required to file s0000.
S0000 form should be filled out with accurate information about the visit.
The purpose of s0000 is to document details about the visit.
The information to be reported includes date, time, location, and purpose of the visit.
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