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DR.

YANGAS HOSPITAL RENAL


CENTER

DR.YANGAS HOSPITAL RENAL


CENTER

DR.YANGAS HOSPITAL RENAL


CENTER

P. Burgos St., Poblacion, Bocaue, Bulacan


Tel. No.: (044) 815-2455

P. Burgos St., Poblacion, Bocaue, Bulacan


Tel. No.: (044) 815-2455

P. Burgos St., Poblacion, Bocaue, Bulacan


Tel. No.: (044) 815-2455

NAME: ______________________________ DATE______________

NAME: ______________________________ DATE______________

NAME: ______________________________ DATE______________

ADDRESS: ________________________AGE:_____SEX:________

ADDRESS: ________________________AGE:_____SEX:________

ADDRESS: ________________________AGE:_____SEX:________

DIAGNOSIS: ___________________________________________

DIAGNOSIS: ___________________________________________

DIAGNOSIS: ___________________________________________

__________________M.D.

__________________M.D.

__________________M.D.

Lic No. ________________

Lic No. ________________

Lic No. ________________

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