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State of ConnecticutDepartment of Public Health01/22 This form may be reproducedMARRIAGE LICENSE WORKSHEET by the local registrars officeSPOUSE ONE NAME SEX(First)SPOUSE TWO(Middle)(Last)DATE OF BIRTH
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The Department of Public Health is a governmental agency responsible for protecting and improving the health of the public through various programs, policies, and regulations.
Individuals and organizations involved in health-related activities, including healthcare providers, businesses, and certain facilities, may be required to file with the Department of Public Health depending on regulations specific to their operations.
To fill out a form for the Department of Public Health, gather the required information, ensure accuracy, and follow the specific guidelines provided by the department, which may include completing online submissions or physical forms.
The purpose of the Department of Public Health is to safeguard community health, prevent disease, promote health education, and enforce health regulations to ensure a healthy population.
The information required may include health statistics, incident reports, compliance data, health service delivery details, and any other information stipulated by health regulations.
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