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HISTORY & PHYSICAL Please print and complete all blanks Patient Name: ___ Todays Date: ___ Date of Birth: ___ What brings you in today? ___ Are you here related to a work injury? ___ Occupation: ___

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New Pediatric-Munford refers to updated guidelines or regulations related to pediatric care and health services in the Munford area.

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Healthcare providers, clinics, and organizations involved in pediatric care in the Munford area are required to file new Pediatric-Munford.

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