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Summary Form (Non-OASIS)

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$89.95
QuantityPrice
1 – 4$89.95
5 – 9$80.90
10 – 14$69.25
15 +$57.40
SKU: 3583/2P
$89.95
Capture patient information for transfer/referral and/or discharge summary for non-OASIS patient discharges. May also be used to analyze reasons for discharge and transfer/referral, and trend thisinformation. Can also beused to collect data for length of stay and retrospective record reviews.
8 1/2" x 11" (detached), 2-part carbonless snap set, white original, canary copy, black ink, standard 5-hole punched top and side, wrapped in 100s.

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