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I have also read him/her the consent form in language and explained its contents to him/her. To the best of my knowledge and belief he/she understood this explanation. Interpreter s Signature HHS-687 10/12 signed the Name of Individual consent form I explained to him/her the nature of sterilization operation Before the fact that it is intended to be a final and irreversible procedure and the discomforts risks I counseled the individual to be ster.

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