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JSON File: ct_transfer_out.json |
Questions | Concepts |
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Receiving Facility __________________________________ | |
Transfer-Out Date (Date transfer-out takes effect) ␣␣-␣␣-␣␣␣␣ 📆 | |
Transfer-out Verified 🔘 Yes 🔘 No 🔘 Unknown | |
Date verification done ␣␣-␣␣-␣␣␣␣ 📆 | |
Notes __________________________________ | |