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PATIENT REGISTRATION OFFICE USE ONLY: Date: ___ Time: ___ AM/Initials ___PATIENT INFORMATION Last Name: ___ First Name: ___Middle Initial: ___ Date of Birth: ___ Social Security Number: _________
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How to fill out office use only date

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Locate the designated field on the document labeled 'Office Use Only Date'.
02
Enter the current date in the specified format (e.g. mm/dd/yyyy).
03
Make sure to use a pen with ink that is easily readable and permanent.
04
Avoid making any additional marks or changes in this section to maintain the integrity of the information.

Who needs office use only date?

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Office use only date is a section on certain forms where only the internal office staff will fill out and use for their records.
The internal office staff or employees responsible for processing the form are required to fill out the office use only date section.
To fill out the office use only date, the internal office staff will input relevant internal tracking information such as date received, processed, and any other internal notes.
The purpose of office use only date is to track internal processing and record-keeping of the form within the organization.
The office use only date section typically includes information such as date received, processed, and any internal tracking details specific to the organization.
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