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Referrral Slip

This referral slip from Redoble Medical Clinic provides information to refer a patient to another doctor. It requests the patient's name, age, sex, address, who they are referred from and to, pertinent findings from the referring doctor, the action already taken, the reason for referral, and any remarks. The referral slip is signed by Dr. Rosendo C. Redoble as the medical director of the clinic.

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1K views1 page

Referrral Slip

This referral slip from Redoble Medical Clinic provides information to refer a patient to another doctor. It requests the patient's name, age, sex, address, who they are referred from and to, pertinent findings from the referring doctor, the action already taken, the reason for referral, and any remarks. The referral slip is signed by Dr. Rosendo C. Redoble as the medical director of the clinic.

Uploaded by

api-3836762
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOC, PDF, TXT or read online on Scribd
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REDOBLE MEDICAL CLINIC

POBLACION BUUG, ZAMBOANGA SIBUGAY

REFERRAL SLIP

DATE:___________________

NAME: _____________________________ AGE: ______ SEX: _________ STATUS

ADDRESS:________________________________

REFERRED FROM: ________________________ REFERRED TO: _______________________

PERTINENT FINDING BY REFERRING:_________________________________________

ACTION TAKEN BY REFERRING: _____________________________________________________

REASON FOR REFERRAL: ____________________________________________________________

REMARKS IF ANY: ___________________________________________________________________

ROSENDO C. REDOBLE, M.D.


MEDICAL DIRECTOR

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