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Questions

Concepts

Visit Date

␣␣-␣␣-␣␣␣␣ 📆

163137AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA

Receiving Facility

__________________________________

162724 Health facility name

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

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160649 Date transferred out

Transfer-out Verified

🔘 Yes

🔘 No

🔘 Unknown

VerificationDone Verification Complete

Date verification done

␣␣-␣␣-␣␣␣␣ 📆

160753 Date of event

Notes

__________________________________

165095 General patient note

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