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Patient Name: Lucile Salter Packard Children's Hospital STANFORD UNIVERSITY MEDICAL CENTER 725 Welch Road, Palo Alto, CA 94304Date of Birth:*L15783×Questionnaire Well Adult Check 1821 Years Page
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What is our new hospital at?
Our new hospital is located at 123 Main Street.
Who is required to file our new hospital at?
The hospital administrator is required to file the new hospital at.
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The new hospital form must include the hospital's address, contact information, and a list of services provided.
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