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Digo Oficina Provincial DATOS DE IDENTIFICACI N DEL PACIENTE 5. NOMBRE DEL (DE LA) PACIENTE: 6. RUT Apellido Paterno Apellido Materno 1. Hombre 2. Mujer 7. SEXO: Nombres 8. FECHA DE NACIMIENTO: 10. UNIDAD DE MEDIDA DE LA EDAD: D a Mes A o 11. NACIONALIDAD 12. PUEBLO ORIGINARIO DECLARADO C digo (S lo extranjeros) 1. D as 2. Meses 3. A os 1. Alacalufe (Kawashkar) 2. Atacame o 3. Aimara 4. Colla 5. Diaguita 9. EDAD 6. Mapuche 7. Quechua 8. Rapa Nui 9. Y mana (Yag n).

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