Page Comparison

Visit Date

␣␣-␣␣-␣␣␣␣ 📆

163137AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA

Receiving Facility

__________________________________

162724AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA162724 Health facility name

Transfer-Out Date (Date transfer-out takes effect)

␣␣-␣␣-␣␣␣␣ 📆

160649AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA160649 Date transferred out

Transfer-out Verified ***

🔘 Yes

🔘 No

🔘 Unknown

797e0073-1f3f-46b1-8b1a-8cdad134d2b3

Date verification done

␣␣-␣␣-␣␣␣␣ 📆

160753AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA160753 Date of event

Notes

__________________________________

165095AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA116509 5General patient note