Saint Barnabas Medical Center of Livingston / Saint Barnabas Medical Center / /
MedicalCondition
HIV / AIDS / INFECTIOUS DISEASES / /
Organization
Saint Barnabas Medical Center / PHYSICAL EXAM PROGRESS NOTES ABSTRACT OPERATIVE REPTS & PATHOLOGY LAB / Health Information Management Department / Saint Barnabas Medical Center of Livingston / / /
MR#________________________ 94 Old Short Hills Road Livingston, NJAUTHORIZATION TO DISCLOSE HEALTH INFORMATION PATIENT NAME: ___________________________________________________ D.O.B.:_____________________________