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    Modality - Studyname Date Study Performed By: Performingphysician - Institutionname Indication Technique Quality Description Conclusion

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    Vico Sotto
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    Modality - Studyname Date Study Performed By: Performingphysician - Institutionname Indication Technique Quality Description Conclusion

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    Vico Sotto
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    Modality - Studyname Date Study Performed By: Performingphysician - Institutionname Indication Technique Quality Description Conclusion

    Uploaded by

    Vico Sotto
    Data

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    Radiology Department University of Cupertino Silicon Valley California, CA 90024 referringPhysician

    Name: name (patientID) Birthdate: dateOfBirth Accession Number: accessionNumber

    Cupertino, today Report modality - studyName date Study performed by: performingPhysician institutionName Indication: Technique: modality: modality, number of images: numberOfImages Quality: Description: Conclusion:

    Sincerely, performingPhysician

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