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 Patient Name Patient Number Birth Date Telephone Prescribing Physician Address Telephone Fax Allergen Extract Content Bottle Nam 2011-2025

2011-2025 Form

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Video instructions and help with filling out and completing Patient Name Patient Number Birth Date Telephone Prescribing Physician Address Telephone Fax Allergen Extract Content Bottle Name Abbreviations Tree T Grass G Weed W Ragweed R Mixture Mx Antigen Number Maintenance Concentrate Form

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Instructions and help about Patient Name Patient Number Birth Date Telephone Prescribing Physician Address Telephone Fax Allergen Extract Content Bottle Name Abbreviations Tree T Grass G Weed W Ragweed R Mixture Mx Antigen Number Maintenance Concentrate

welcome to ABC Pediatric Clinic let's now move on to the third tab patient information under this tab you will find 10 options number one allergies number two forms number three growth chart number four immunization or shot records number five labs number six handouts number seven patient information number eight prescriptions number nine problem list number 10 visit history let's look at the Energy tab in this tab you will find your child's medication to allergies as well as food allergies listed you see that the patient is allergic to penicillin which causes the patient to get hives the patient's food allergies is to peanuts which causes tongue swelling let's look at the forms tab in this tab you will find forms you have requested from our office simply choose the form you would like to see and click View you will then receive a pop-up on your screen click on open and ok this is just an example of how to print out a form just click on print on

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