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330507 West Broadway Avenue Vancouver, BC V5Z 1E6 t 604.872.5484 f 604.708.0748 www.crossroadsobgyn.caREFERRAL FORM GYNECOLOGY Your office will be informed of appointment date and time. FAX TO 604.708.0748 Date:
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330-507 West Broadway Avenue refers to a specific address, which may relate to a business or property in that location.
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