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Burn Form

Burn Form

Use a Burn Form 0 template to make your document workflow more streamlined.

M’s name, address and date of birth      D. Area(s) of body injured                                               G. Apparent cause of burn injury        B. Address when burn injury occurred                E. Degree of burns and percent of body burned        H. Name and address of repor ng facility       C. Date and  me of injury                                      F. Injury severity                                                               I.  A...
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