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ACTION: OriginalDATE: 12/15/2010 4:21 PMRule Summary and Fiscal Analysis (Part A) Department of Health Agency NameCarol L. Ray DivisionContact246 North High Street Columbus OH 4321500006146441407Agency
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3701-31-04 new is a form established by public health authorities for reporting specific health-related data as part of regulatory compliance.
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Required information includes demographic data, health services provided, outcomes, and any additional data as specified in the form instructions.
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