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Form 10 Ia

Form 10 Ia

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From autism/cerebral palsy/multiple disability. 2. This condition is progressive/non-progressive/likely to improve/not likely to improve. 3. Reassessment is recommended/not recommended after a period of _______________ months/years. (Neurologist/Pediatric Neurologist/Civil Surgeon/ Chief Medical Officer) Name : Address of Institution/Government hospital : Qualification/designation of specialist : SEAL Signature/Thumb impression of the patient Note: Strike out whichever is not...
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