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Get and Sign Hr Ext GYNAECOLOGIC CYTOLOGY NON Dynacare 2015 Form

Get and Sign Hr Ext GYNAECOLOGIC CYTOLOGY NON Dynacare 2015 Form

Name: Hr Ext GYNECOLOGIC CYTOLOGY NON Dynamic - Fill Out and Sign Printable PDF Template | signNow
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Clinical Status Pregnancy wks Spatula Patient History Is Patient Vaccinated for HPV Result/Date Biopsy Peritoneal Left Right Cyst Multi Sputum Nodule Nipple Discharge Yes No Fixative Added Thick HPV/DNA TEST IF ASCUS Scanty Bloody Watery Color Clear Turbid Volume Date Revised by Sue Clipsham Description I hereby certify the tests ordered are not for registered In or Out patients of a Hospital. Revision 1 Single Clinical History/Remarks Note Patient will be billed for testing Pleural Partial -...

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