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Medicare card / Medicare / Pharmaceutical Benefits Scheme / Healthcare in Australia / Health / Medicine


Authority to release personal Medicare and Pharmaceutical Benefits Scheme claims information to a third party 3 Date of birth Important information Complete this form to authorise the release of personal Medicare or
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Document Date: 2014-09-09 01:48:51


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File Size: 177,07 KB

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Company

TAS SA / /

Currency

USD / /

Facility

Dr B Brown Sth Melbourne Pharmacy / Dr S Smith One Stop Pharmacy / /

Organization

Department of Health / Department of Veterans / Medicare / /

Person

Smith / Tick / Hope Pl / /

/

Position

Governor / /

Product

PARACETAMOL TABLET / OXAZEPAM / /

ProgrammingLanguage

K / /

Technology

cellular telephone / /

URL

www.medicareaustralia.gov.au / /

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