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Date attending MD referred patient for:Date:Pt:Respiratory therapy treatment:Qn

Known as: ??????????:??:???:??????:???, ???? ??????? ??????? ???? ???????? ???????? ?:????:??????:????????????? ??????? ???????:?????, DATE ATTENDING MD REFERRED PATIENT FOR:marca de tiempo:fecha y hora:punto en el tiempo:tratamiento respiratorio:cuantitativo 
National Institutes of Health

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2005