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Regional Memorial Hospital Inpatient Report Checklist
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Patient First Name
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Patient Last Name
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Patient MRN #
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Patient Date of Birth
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H&P Report Enter or Attach
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H&P Report Completed
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Anesthesia Report Enter or Attach
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Anesthesia Report Completed
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Discharge Summary Enter or Attach
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Discharge Summary Report Completed
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Name of Beneficary
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Date of Service
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Inpatient Certification
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