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Presidency of Lyndon B. Johnson / Government / Federal assistance in the United States / Healthcare reform in the United States / Medicare


Runaway Bay Sport & Leadership Excellence Centre FORM C STUDENT MEDICAL CONSENT NOTE PLEASE COPY BACK TO BACK SURNAME:
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Document Date: 2014-06-10 23:48:09

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File Size: 307,00 KB

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MedicalCondition

Allergy / complete additional information sheet Asthma / Measles / YES NO Food Allergies / Chicken pox / autism / infectious disease / /

MedicalTreatment

BLOOD TRANSFUSION / /

Organization

Medicare / /

Position

General Practitioner / /

Product

penicillin / Epipen / /

Technology

cellular telephone / /

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