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The document is an Outpatient Laboratory Requisition form that outlines the necessary information and procedures for patients undergoing laboratory tests. It includes sections for patient details, ordering physician information, test selections across various categories (hematology, chemistry, microbiology, etc.), and instructions for both patients and laboratory staff. The form emphasizes the importance of completing highlighted fields to prevent delays and provides guidelines for specific tests, including fasting requirements and contact information for various laboratory locations.

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