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Get CT Scan Requisition - Ross Memorial - Rmh

RMH Use Only C.T. Scan Requisition 10 Angeline St. N., Lindsay, ON, K9V 4M8 Tel: 7053286196 Fax: 7053286197 Circle: OP or IP or Emerg Rm #: & Ext # Name: Address: City: Phone: Date of Birth: OHIP:.

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