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  • Comfort Medical Center

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    senkatuuka
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    THIS DOCUMENT GIVES YOU A FORMAT FOR MEDICAL FORM

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    THIS DOCUMENT GIVES YOU A FORMAT FOR MEDICAL FORM

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    11 Ansichten2 Seiten

    Comfort Medical Center

    Hochgeladen von

    senkatuuka
    THIS DOCUMENT GIVES YOU A FORMAT FOR MEDICAL FORM

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Als DOCX, PDF, TXT herunterladen oder online auf Scribd lesen
    Markieren Sie unangemessene Inhalte
    von 2

    COMFORT MEDICAL CENTER - NABBINGO

    TEL: 0774408658/0779525701/0782623349
    NAME:………………………………………………………AGE:………….SEX:……………
    ADDRESS……………………………………………………….DATE………………………
    LAB NO:………………………………
    HIV TEST RESULTS
    Has been tested HIV 1 & 2 and tested NEGATIVE
    Test after three months . Do not lose this form.

    TESTED BY: …………………………………………………..


    SIGNATURE:……………………………………………..……

    COMFORT MEDICAL CENTER - NABBINGO


    TEL: 0774408658/0779525701/0782623349
    NAME:………………………………………………………AGE:………….SEX:……………
    ADDRESS:……………………………………………………….DATE:………………………
    LAB NO:………………………………
    HIV TEST RESULTS
    Has been tested HIV 1 & 2 and tested NEGATIVE
    Test after three months . Do not lose this form.

    TESTED BY: …………………………………………………..


    SIGNATURE:……………………………………………..……

    COMFORT MEDICAL CENTER - NABBINGO


    TEL: 0774408658/0779525701/0782623349
    NAME:………………………………………………………AGE:………….SEX:……………
    ADDRESS:……………………………………………………….DATE:………………………
    LAB NO:………………………………
    HIV TEST RESULTS
    Has been tested HIV 1 & 2 and tested NEGATIVE
    Test after three months . Do not lose this form.

    TESTED BY: …………………………………………………..


    SIGNATURE:……………………………………………..……

    COMFORT MEDICAL CENTER - NABBINGO


    TEL: 0774408658/0779525701/0782623349
    NAME:………………………………………………………AGE:………….SEX:……………
    ADDRESS:……………………………………………………….DATE:………………………
    LAB NO:………………………………
    HIV TEST RESULTS
    Has been tested HIV 1 & 2 and tested NEGATIVE
    Test after three months . Do not lose this form.

    TESTED BY: …………………………………………………..


    SIGNATURE:……………………………………………..……
    COMFORT MEDICAL CENTER - NABBINGO
    TEL: 0774408658/0779525701/0782623349
    NAME:………………………………………………………AGE:………….SEX:……………
    ADDRESS……………………………………………………….DATE………………………
    LAB NO:………………………………
    HIV TEST RESULTS
    Has been tested HIV and tested POSITIVE
    Do not lose this form.

    TESTED BY: …………………………………………………..


    SIGNATURE:……………………………………………..……

    COMFORT MEDICAL CENTER - NABBINGO


    TEL: 0774408658/0779525701/0782623349
    NAME:………………………………………………………AGE:………….SEX:……………
    ADDRESS……………………………………………………….DATE………………………
    LAB NO:………………………………
    HIV TEST RESULTS
    Has been tested HIV and tested POSITIVE
    Do not lose this form.

    TESTED BY: …………………………………………………..


    SIGNATURE:……………………………………………..……

    COMFORT MEDICAL CENTER - NABBINGO


    TEL: 0774408658/0779525701/0782623349
    NAME:………………………………………………………AGE:………….SEX:……………
    ADDRESS……………………………………………………….DATE………………………
    LAB NO:………………………………
    HIV TEST RESULTS
    Has been tested HIV and tested POSITIVE
    Do not lose this form.

    TESTED BY: …………………………………………………..


    SIGNATURE:……………………………………………..……

    COMFORT MEDICAL CENTER - NABBINGO


    TEL: 0774408658/0779525701/0782623349
    NAME:………………………………………………………AGE:………….SEX:……………
    ADDRESS……………………………………………………….DATE………………………
    LAB NO:………………………………
    HIV TEST RESULTS
    Has been tested HIV and tested POSITIVE
    Do not lose this form.

    TESTED BY: …………………………………………………..


    SIGNATURE:……………………………………………..……

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