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Date Completed: ___ Pa ent Name:___ Date of Birth:___ Gender:___ Form Completed by:___ Rela onship:___Pregnancy and Birth HistorySocial historyHospital Born at: ___ Illness During Pregnancy: No Yes___
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Timing of pregnancy refers to the specific period during which a pregnant individual is expected to deliver based on their last menstrual period or ultrasound measurements.
Individuals who are pregnant or their healthcare providers may be required to file timing of pregnancy details for medical records or insurance purposes.
To fill out timing of pregnancy, individuals should provide the date of the last menstrual period, any relevant ultrasound dates, and the expected due date as indicated by their healthcare provider.
The purpose is to track the progression of the pregnancy, facilitate proper medical care, and ensure timely interventions if necessary.
Information that must be reported includes the last menstrual period date, estimated due date, any complications, and ultrasound results if applicable.
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