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Ct medical report form

P 142d form 2025

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The document is a medical report from the State of Connecticut's Department of Motor Vehicles concerning a patient's ability to safely operate a motor vehicle, specifically addressing diabetes-related health issues. It requires a licensed medical professional to evaluate the patient within 90 days and provide information on their diabetes management, symptoms, and any potential risks associated with driving. The report includes sections for patient details, medical history, and the physician's certification regarding the patient's fitness to drive.

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