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Get Weill Cornell Medicine WCM Breast Pathology Slide Return Form 2020-2024

Y 10065 Tel:212-746-6482 Fax:212-746-6484 Complete form and return by FAX to 212-746-6484 or e-mail: cornellpathologyconsults med.cornell.edu WCM Breast Pathology Slide Return Form Date: Institution Information Institution: Address: City/State/Zip: Phone: Fax: Email: Contact person: Patient Information Date of Birth: Patient Name: Sex: Male Female Our Accession Number (SC): Courier Information (Required) DHL Express Federal Express United Parcel Service (UPS) Other.

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