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BLUESKY MEDICAL CLINIC & LAB SERVICES BLUESKY MEDICAL CLINIC & LAB SERVICES

FOR: Minor Surgery, Family Planning Services, Medical Consultation, Pediatric Service,
Laboratory Services Obs & Gymea FOR: Minor Surgery, Family Planning Services, Medical Consultation, Pediatric Service,
Located Along Rhino Camp Road Opposite Najah Islamic P/S Laboratory Services Obs & Gymea
Located Along Rhino Camp Road Opposite Najah Islamic P/S
Tel:077533246
Tel:077533246

Medical Form Medical Form


Name ………………………………………………….…………..……... Name ………………………………………………….…………..……...
Address ……………………………………………………..……….…… Address ……………………………………………………..……….……
Age: ………………………… Sex …………...… Weight ……………... Age: ………………………… Sex …………...… Weight ……………...
Diagnosis: ……………………………………..…………………………. Diagnosis: ……………………………………..………………………….
DATE DATE
CLINICAL NOTES CLINICAL NOTES

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