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PATIENT NAME: ___ DATE : ___
SURGEON: PAGAN J. SINGH, M.D.
PREOPERATIVE DIAGNOSIS: RETINAL TEAR, OD / OS
POSTOPERATIVE DIAGNOSIS: RETINAL TEAR, OD / OS
NAME OF OPERATION: ARGON LASER PHOTOCOAGULATION
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Start by entering the patient's full name in the appropriate field on the form.
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Who needs care of form patient?
01
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Patients who have specific medical needs that need to be communicated to a caregiver.
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What is care of form patient?
The care of form patient is a document that designates someone to make medical decisions on behalf of a patient who is unable to do so themselves.
Who is required to file care of form patient?
The patient or their legal guardian is required to file the care of form patient.
How to fill out care of form patient?
To fill out the care of form patient, one must provide their personal information, contact details, and specify their medical decision-making preferences.
What is the purpose of care of form patient?
The purpose of the care of form patient is to ensure that patients receive appropriate medical treatment in accordance with their preferences, even if they are unable to communicate them.
What information must be reported on care of form patient?
The care of form patient must include the patient's name, date of birth, medical conditions, and the name of the designated decision-maker.
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