Form 3647-2025

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4.8 out of 5

42 votes

The document is an Inpatient Treatment Record Cover Sheet used for documenting patient information and administrative data related to inpatient medical treatment. It includes fields for personal details such as name, age, sex, race, and military service information, as well as admission details, diagnoses, procedures, and days of care at the medical facility.

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Versions	Form popularity	Fillable & printable
1979	4.8 Satisfied (42 Votes)

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