Patient Record Form

National Ambulatory Medical Care Survey

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0920-0234 can be found here:

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Attachment D-2014 Patient Record Form (PRF)

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14 minutes

File Type	application/vnd.openxmlformats-officedocument.wordprocessingml.document
Author	CDC User
File Modified	0000-00-00
File Created	2021-01-26