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(i.e. hospital discharge papers; work release form; prescriptions) Please complete this block prior to submitting for other types of incidents and describe the incident and corrective actions in the space provided at the end of this report. ...

http://artis.apexcos.com/HealthSafety/HS_New/Forms/Blank%20Incident%20Report%20Form.doc

Date added: June 3, 2014 - Views: 2

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www.courts.ca.gov

The decedent was transferred within the hospital the following day and later that day signed discharge papers acknowledging that he ... operative complaint. (Blank v. Kirwan ... the decedent was permitted to sign discharge papers so the hospital and the health care professionals ...

http://www.courts.ca.gov/opinions/nonpub/B234051.DOC

Date added: July 12, 2013 - Views: 10

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Pennsylvania

... recording and access to copies of military discharge papers. ... real property); Section 35-4-130 (lis pendens and hospital liens); Sections 36-5-3 ... of it shall be printed in the form of discharge papers, with sufficient blank lines for the recording of such dates as may be ...

http://www.ernstpublishing.com/public/State%20Statutes.doc

Date added: October 7, 2011 - Views: 24

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CHAPTER V: - Maine Health Information - mehima

Miscarriage reporting Chapter 5, section ... miscarriages, induced abortions, and deaths. All hospitals should have as references the "Hospital Vital Statistics Handbook" and "Vital Statistics ... -- The person who "assembles the discharge papers" will check that a specimen has been ...

http://www.mehima.org/legalmanual/Ch%205%20Reporting%20April%202006.doc

Date added: May 23, 2013 - Views: 24

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M21-1, Part 3, Change Document 131 - VA - Veterans Benefits ...

Clinical records are filed by the military hospital or other military medical facility which provided treatment. ... O27 RESERVED Blank – reserved for later use. ... discharge papers, MABMC-11 (discharge order) and service records usually provided Pages 3, 5-6, 8-9, 12-13, and 17 included ...

http://www.benefits.va.gov/warms/docs/admin21/m21_1/part3/chg131.doc

Date added: October 9, 2011 - Views: 52

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Massachusetts - Mass.Gov

... the hospital discharge planner, ... makes 2 copies of the original "Local Certification" papers, the attached documentation reports and the police form. The following folders are then prepared: ... Leave blank. The Division completes this upon data entry.

http://www.mass.gov/eohhs/docs/dph/cdc/tb/nursing-case-protocols.doc

Date added: May 28, 2012 - Views: 23

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PACE Contract Boilerplate - California Department of Health ...

... to inspect any and all working papers related to the preparation of the audit report. ... and coordinated hospital discharge planning that includes necessary post ... This Attachment Intentionally Left Blank 1 page M. Exhibit A, Attachment 13 - Member Services 7 pages N. Exhibit A ...

http://www.dhcs.ca.gov/services/ltc/Documents/PACE%20Boilerplate%20Contract.Updated%2012.2012.doc

Date added: April 19, 2013 - Views: 20

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Sample Promissory Note - HowStuffWorks

This is an unsecured note. Borrower agrees that until the principal and interest owed under this promissory note are paid in full, ... modification, waiver, or other indulgence or discharge or release of any obligor hereunder or exchange, substitution, ...

http://static.howstuffworks.com/pdf/samp-promissory.doc

Date added: September 15, 2011 - Views: 346

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Organized Form The Start, Inc - Baby Briefcase

the baby or the paperwork ... paperwork her new baby would bring. Birth certificate, discharge papers, immunizations and vaccinations, social-security card, gift cards, thank-you notes: the towering pile kept growing. “As a new parent, you come home from the hospital laden with ...

http://www.babybriefcase.com/downloadable_files/BabyBriefcasePressRelease0704.doc

Date added: November 23, 2011 - Views: 6

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FAMILY INFORMATION GUIDE - wells-financial

family information guide _____ vital statistics and historical data. full name ... location of discharge papers: in home other _____ spouse ... other insurance (ad&d, hospital, rx, vision, dental, ...

http://www.wells-financial.com/uploads/4_FAMILY_INFORMATION_GUIDE_updated_062408.docx

Date added: August 18, 2013 - Views: 3

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Introduction

The database search was limited to English-language papers. ... FS Blank, HA Smithline, EA Henneman. Journal of Emergency Medicine Jun 2011;40(6):613-616. ... Accuracy of medication documentation in hospital discharge summaries: ...

http://www.medicinesresources.nhs.uk/upload/documents/Evidence/Medicines%20Management/mm-reconciliation-2011-final.doc

Date added: August 2, 2013 - Views: 7

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DATA DICTIONARY - Iowa Hospital Association

DISCHARGE DATE : The month, day, and ... The condition established after study to be chiefly responsible for occasioning the admission of the patient to the hospital for care. (Use ICD-9-CM ... E-Codes). Decimals are assumed, for example, E-Code of E849.0 is recorded E8490. Field will be blank ...

http://www.ihaonline.org/imis15/Images/IHAWebPageDocs/infoservices/Inpatient%20and%20Outpatient%20Services/OP%20Data%20Dictionary%202011%202Q.doc

Date added: August 21, 2013 - Views: 14

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INSTITUTE FOR THE ADVANCMENT OF SOCIAL WORK RESEARCH

CALL FOR PAPERS: THE IMPACT OF INSTITUTIONS ON ADULT ... at the University of Michigan has recently released the dataset “National Hospital Discharge Survey, 2003 (#4220)” which may be of interest ... Send email to [email protected] Leave subject line blank and type in ...

https://www.naswdc.org/research/call/041405.doc

Date added: May 23, 2013 - Views: 11

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Birth3 - Texas Department of State Health Services

Corrections to Birth Certificate Records The Certificate of Birth is a permanent legal ... may be used in requesting completion of any item left blank on the original birth certificate or to correct any errors made ... A copy of official discharge papers of the Army, Navy ...

http://www.dshs.state.tx.us/vs/handbooks/birth/birth3.doc

Date added: September 15, 2011 - Views: 40

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DATA DICTIONARY - Iowa Hospital Association

Length of time patient stayed in hospital. From admission to discharge. 10 sex code: (UB-04 ... If SSN was not supplied the patient ID will be blank. ... e.g. SCHIP otherwise known as HAWK-I) 03 Iowa State Government (e.g. Mental Health State Papers, Iowa Cares, etc.) 04 County/Local ...

http://www.ihaonline.org/imis15/Images/IHAWebPageDocs/infoservices/Inpatient%20and%20Outpatient%20Services/IP%20Data%20Dictionary%202011%202Q.doc

Date added: October 17, 2013 - Views: 13

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COURSE DESCRIPTION - Council on Social Work Education

Papers will be marked down for being below ... M., Fitzgerald, L., Haesler, E., & Manfrin, M. (2009). Hospital discharge planning for frail older people and their family. Are we delivering best practice? A review of the evidence. Journal of Clinical Nursing, 18(18), 2539-2546. Blank,T., Asencio ...

http://www.cswe.org/File.aspx?id=55792

Date added: May 6, 2013 - Views: 3

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Individual Characteristics Form - DASHBOARD - REGINFO.GOV

Enter a check mark ( ( ) in the corresponding blank. If Yes, enter date and year. Box 7: Name of Individual. Enter full name of Individual or ... Hospital Record of Birth. FAMILY INCOME: (Required for Ex-felon) Pay Stubs. ... Discharge Papers* VOCATIONAL REHABILITATION REFERRAL: Voc ...

http://www.reginfo.gov/public/do/DownloadDocument?documentID=18494&version=1

Date added: June 3, 2014 - Views: 1

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www.castonline.ilstu.edu

Therapeutic Recreation Internship ... and fill in the number of clients in the blank next to the ... Physical Medicine and Rehabilitation Treatment/Rehabilitation Hospital Based Inpatient Day Treatment Outpatient Treatment/Rehabilitation Non-Hospital Based Long Term Health ...

http://www.castonline.ilstu.edu/klitzing/internship%20papers/Therapeutic%20Recreation%20Internship%20Site%20Info%20Form%202011.doc

Date added: June 29, 2013 - Views: 4

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A PROJECT REPORT ON - Projects Org

Hospital Management System provides the benefits of streamlined operations, ... Doctor, Wards, , Admin, Store, Patient appointment, bill payment, record modification, discharge details etc. TABLE OF CONTENT. ... papers are needed to be handled and taken care of.

http://projectorg.files.wordpress.com/2012/10/hospital-management_project-report.doc

Date added: October 7, 2013 - Views: 238

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AUTHORIZATION TO RELEASE MEDICAL INFORMATION

Discharge summary. Complete hospital chart. Office notes. Outpatient records Lab reports. ... Instructions for Authorization to Release Medical Information. ... and this is also why the second page of this document is blank.

http://www.awppw.org/docs/Generic.HIPAA.authform.doc

Date added: October 13, 2011 - Views: 1066

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Family Information - Operation We Are Here

Hospital Tracker Special Care Organization Record ... This page intentionally left blank Medical Bill Tracker Special Care ... of All Contracts and Loans Pet Health/Vaccination Records Birth Certificates Adoption Papers Death Certificates Divorce Papers Discharge Papers (DD 214) Car Title ...

http://www.operationwearehere.com/SCOR_2.doc

Date added: April 26, 2012 - Views: 9

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Managing Hospital Records - International Records Management ...

Hospital Records INTERNATIONAL. COUNCIL ON ARCHIVES. INTERNATIONAL RECORDS . ... Minutes and papers of major committees and of the governing body, ... Records procedures on the discharge or death of a patient are described in Lesson 4.

http://www.irmt.org/documents/educ_training/public_sector_rec/IRMT_hospital_recs.doc

Date added: October 25, 2011 - Views: 90

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J - Independence Seaport Museum

... charts for determining ballast requirements; blank inspection report forms; a blank checklist for official ... Materials related to John MacDonald include: discharge papers from the U.S. Coast Guard-Merchant ... crew lists for SS Pine Bluff Victory; a hospital ledger book and ...

http://www.phillyseaport.org/images/Archives/ISM-WWII.doc

Date added: May 4, 2013 - Views: 18

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M21-1, PT V, Chapter 23, Change 9 - Veterans Benefits ...

separation papers (DD214 or other document) from service. Enclosure: ... we will reduce letter A or I (blank for origi-451105 our evaluation of the veteran's service-connected malaria to nals), ... the end of the month of your hospital discharge; or a subsequent evaluation (2) ...

http://www.benefits.va.gov/warms/docs/admin21/m21_1/part5/ch23.doc

Date added: October 22, 2011 - Views: 27

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Ob/Gyn Intern Orientation and Survival Guide

Ob/Gyn Intern Orientation and Survival Guide ... If you are to use a blank ... Discharge Orders SVD- 24-48 hr postpartum; c-sections 48-72hr ...

http://slfp.net/uploads/internsurvive.doc

Date added: December 1, 2012 - Views: 12

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www.daltonwealth.com

Hospital (preferred): Human resources contact (current or prior employment): ... Adoption papers. Birth certificate. Driver’s license. Marriage certificate. ... Military discharge papers. Pre-paid funeral documentation. Other:

http://www.daltonwealth.com/new/daltonwealthmanagement/content.asp?contentid=2017685715

Date added: June 28, 2014 - Views: 2

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ENVIRONMENT OF CARE CLARIFICATIONS - Navy

Stairs that extend beyond (go past) the level of discharge (ground floor) must be interrupted (stopped) at the level of ... Hospital staff could explain and highlight hospital restraint use ... The best practice may be to fill out the top part of a blank part 4, and then draw a line ...

http://www.med.navy.mil/sites/nmcp/EduTrain/Documents/FacMgmt/EnvironmentOfCareClarificationsSept2002.doc

Date added: April 14, 2012 - Views: 51

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APACHE GAMING COMMISSION - Delaware Nation

Copy of DD 214 (Military Discharge Papers) ... Complete the application form in it’s entirely (no questions should be left blank). ... lending institutions, medical institutions, hospital and health care professionals.

http://delawarenation.com/Portals/0/PDF/gamingcommission/NewPDF1/Vendor%20Tech%20Application.docx

Date added: July 17, 2013 - Views: 2

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C2005 Evidence Evaluation Template - Oct.14, 2003

The remainder were general discussion papers or studies relating to other aspects of early ... Pittard 2003 E 1 2 3 4 5 6 7 8 Level of Evidence A = Return of spontaneous circulation C = Survival to hospital discharge E = Other ... REMEMBER TO SAVE THE BLANK WORKSHEET TEMPLATE ...

http://circ.ahajournals.org/content/suppl/2005/11/09/CIRCULATIONAHA.105.170522.DC214/W128B_Parr_Cretikos.doc

Date added: March 19, 2014 - Views: 1

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Attachments - New York State Department of Health

It has produced several issue papers explaining the conceptual framework for ... summary Comments Home to acute care and acute care to nursing home Acute care and Nursing home staff Pertinent hospital admission/discharge information to including a complete medication list ... Blank line and/or ...

http://www.health.ny.gov/funding/rfa/inactive/0903160302/attachments.doc

Date added: July 4, 2012 - Views: 12

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COLLINS CAREER

Collins Career Center. 11627 State Route 243. Chesapeake, OH ... Discharge papers from the hospital or original subpoena document must accompany the request for ... Any missed exams will be given in a different format from original test and may consist of fill in the blank and essay questions.

http://www.collins-cc.edu/docs/RadTech/Rad%20Tech%20Policy%20Handbook%202013-2014%20(revised%201.30.14).doc

Date added: March 15, 2014 - Views: 1

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C2005 Evidence Evaluation Template - Oct.14, 2003

... (dose, route); specific outcomes (ROSC vs. hospital discharge). ... the Cochrane Database of Systematic Reviews on 2/2/04 using search terms “ventilation before naloxone.mp” yielded 0 papers, “naloxone.mp” yielded 27 papers, ...

http://www.circ.ahajournals.org/content/suppl/2005/11/09/CIRCULATIONAHA.105.170522.DC26/W18_Scalzo.doc

Date added: December 10, 2013 - Views: 8

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SECTION 1 - American Legion

discharge or honorable separation, or continued honorably after any of said periods; ... An unmarked (blank) ballot is just a scrap of paper and is not counted in ... orders and other process and papers of the subcommittee or the Department organization of The American Legion may be served ...

http://www.legion.org/documents/word/pogsection4_06.doc

Date added: January 11, 2013 - Views: 26

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Handbook on Death REgistration - Texas Department of State ...

A long-term care facility is not a hospital but provides patient care beyond custodial care (e.g., nursing home, skilled nursing facility, long-term care facility, ... Leave blank if injury was not a transportation injury. 40a. Date of ... Serial number of discharge papers or adjusted service ...

http://www.dshs.state.tx.us/vs/handbooks/death/chapter-4.doc

Date added: May 8, 2013 - Views: 8

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Improving Care Transitions - Welcome to Aging and Disability ...

... any medication lists you have, and the discharge summary from the hospital. Great—I’ll see you in [days/time]. ... medications lists and papers from the hospital? ... You should see a blank spot for questions. Patient: Okay, ...

http://communitychoices.info/adrc/docs/ADRC%20CTI%20Booklet%20June%202009%20updated%2011-12-09.doc

Date added: August 18, 2013 - Views: 1

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SECTION 16 - Western New York Law Center

J. Hospital indemnity or other fixed dollar ... Original or notarized copy of the veteran’s discharge papers. Date Entered the Country . Documentation ... The plan must send a blank Growing Up Healthy or Access New York Health Care application and a letter to the family informing them that ...

http://wnylc.com/health/afile/93/121/

Date added: September 23, 2011 - Views: 21

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Fayetteville State University Institutional Review Board ...

Data already collected for administrative purposes (e.g., Medicare data, hospital discharge data) Medical records ... You may keep a blank copy of this form for your records ... If you have any questions about this research study you can contact me at <<provide your phone ...

http://www.uncfsu.edu/Documents/Research/2012-2013_Application_for_the_Use_of_Human_Subjects_in_Resea%5B1%5D.doc

Date added: May 9, 2013 - Views: 17

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METHODIST HOSPITALS OF DALLAS - Methodist Health System

25.3 Hospital Orientation 86. Methodist Health System Medical Staff Practitioners ... (incomplete means if any sections of the application are left blank or additional ... Dentist’s or Podiatrist’s temporary privileges effective as of the discharge from the hospital of the ...

http://www.methodisthealthsystem.org/documents/Medical%20Staff/01%2D23%2D07%20MHS%20Policies.doc

Date added: May 9, 2013 - Views: 8

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CHAPTER 100–GENERAL INFORMATION - West Virginia

Hospital admissions for diagnostic procedures may be reimbursed only when there is adequate documentation the procedure cannot be performed on an outpatient basis. ... the initial observation care and the observation care discharge services.

http://www.dhhr.wv.gov/bms/Diabetes%20Education/Documents/Chapter%20519%20Practitioners%20080415.doc

Date added: October 3, 2011 - Views: 171

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AAP Screening-ScreenMaterials-NBScatergorizedcompend.doc

All selected papers were read by two or three experts and were critically appraised using a standard format. Seven criteria for a screening programme, ... (55 324 infants) were screened for hearing acuity before hospital discharge, ...

http://www.medicalhomeinfo.org/downloads/docs/NBScategorizedcompend.doc

Date added: September 30, 2011 - Views: 40

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COLLINS CAREER

Discharge papers from the hospital or original subpoena document must accompany the request for this LOA. ... Any missed exams will be given in a different format from original test and may consist of fill in the blank and essay questions.

http://www.collins-cc.edu/docs/RadTech/Rad%20Tech%20Policy%20Handbook.doc

Date added: January 14, 2014 - Views: 1

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... Document Retrieval - The United States Social Security ...

Memorial Hospital discharge summary dated July 1, ... Use blank SSA letterhead (SSAL-951/SSAL-8052). For a child's claim, ... The ALJ also can require people to bring important papers to your hearing and give facts about your case.

http://www.ssa.gov/disability/Documents/Prototype_Operating_Instructions.doc

Date added: October 2, 2011 - Views: 81

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www.maine.gov

The state had just released their first reports of hospital-specific sentinel events. ... These patient safety advocates and subject matter experts were invited to contribute papers that address specific topics ... Continuity of Care and Patient Outcomes After Hospital Discharge. Journal of ...

http://www.maine.gov/dhhs/reports/sentinel_events_report.doc

Date added: November 29, 2012 - Views: 25

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www.aacvpr.org

... on which the secretary checks off the appropriate box and fills in the blank of the start date/time for Cardiac Rehab. ... and position papers regarding the care of persons ... A hospital discharge summary or office note may potentially be formatted to include the necessary patient ...

http://www.aacvpr.org/Portals/0/committeeresource/cac/Converted%20toolkit.doc

Date added: October 17, 2012 - Views: 29

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Chapter 1

Upon discharge from the hospital, you will be given medications to prevent infection. ... Blank forms left to be filled out by the office staff may take longer to process. ... - you will receive your stem cells and remain in hospital until your stem cells are able to grow on their own.

http://www.stemcell-immunotherapy.com/pdfs/handbook.doc

Date added: September 5, 2011 - Views: 25

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A Cardiologist's View - Health Professions Institute

Introduction to Cardiology Transcription. by Linda C. Campbell, CMT, ... and it is usually dictated just before or after the patient is discharged from the hospital. The Discharge Summary contains the following information: ... gather your papers and supplies together, ...

http://www.hpisum.com/Campbell,%20Introduction%20to%20Cardiology%20Transcription.doc

Date added: May 2, 2013 - Views: 9

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SA01 Policy for thr Development, Ratification, Implementation ...

Upon receipt of Section papers MHLAO will check rights have ... The Responsible Clinician may or may not have the power to grant leave of absence and/or discharge from hospital depending on whether the Bail Conditions authorise ... BLANK FORM; ACTIONS; Access to Documentation. CQC Where to find ...

http://www.merseycare.nhs.uk/Library/Who_we_are/Policies_and_Procedures/MH01-MHA%201983%20Overarching%20Policy%20-%20Uploaded%2030th%20Jan%202014%20-%20Review%20Nov%202016.docx

Date added: March 10, 2014 - Views: 3

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Review of the Implementation of Care Plus - Ministry of Health NZ

Some of the remaining practices simply left the section blank, ... Table 12: Hospital discharge profiles for Care Plus patients ... and some post-grad papers in chronic disease. The training needs to be practically based.

http://www.health.govt.nz/system/files/documents/publications/review-implementation-care-plus.doc

Date added: April 9, 2012 - Views: 7

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Health Eligibility Case Management System

Otherwise, it will remain blank. For the Confinement Location field, select from the dropdown. For the Camp field, ... update Veteran Discharge Due to Disability information? In this scenario we're going to update a Veteran's Discharge Due to Disability information.

http://www.va.gov/vdl/documents/HealtheVet/VA_Enrollment_System/esr_3_12_user_manual.doc

Date added: October 11, 2013 - Views: 9

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POCT_LMPG_final_rev41706.doc - AACC - American Association ...

More recently, it has taken on increased importance due to factors such as early hospital discharge, increased prevalence of breastfeeding, and lack of adherence to prompt post-discharge follow-up testing of newborns (1,2).

http://www.aacc.org/SiteCollectionDocuments/NACB/LMPG/EB_POCT/POCT_LMPG_final_rev41706.doc

Date added: July 31, 2012 - Views: 218