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Get Canada NYGH PS253 2018-2024

E provided at time of booking Name: Date of Birth: (last, first) (DD/MM/YY) Phone #: Gender: M / F HC # Provider s Name: Phone #: Billing #: Copy to: Provider s Signature: Clinical Information: CARDIOLOGY TESTS EXERCISE STRESS TEST: NUCLEAR CARDIOLOGY IMAGING: Graded Exercise Stress Test ** Myocardial Perfusion Imaging ** with Exercise Stress (continue on meds AMBULATORY MONITORING: Holter Monitor Recording 72 Hour 14 days 24 Hour N) with Pharmacological Stress ( Persanti.

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