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Form 4 Pulling and re-filing Patient Record form (Line 4)
National Ambulatory Medical Care Survey
NAMCS 10-12 OMB ATT F
Pulling and re-filing Patient Record form (Line 4)
OMB: 0920-0234
OMB.report
HHS/CDC
OMB 0920-0234
ICR 201010-0920-006
IC 181891
Form 4 Pulling and re-filing Patient Record form (Line 4)
( )
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0920-0234 can be found here:
2022-10-21 - Revision of a currently approved collection
2021-06-01 - Revision of a currently approved collection
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