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Get SSA-455-OCR-SM 2003

Ew now. Question 6.a Have You Been Hospitalized Or Had Surgery? Place an “X” in the box below “NO” if you have not been hospitalized or not had surgery during the report period. If you have been hospitalized or had surgery during the report period, then place an “X” in the box below “YES” and answer question 6.b. If You Need Help To Answer The Report It is important that information you give us is accurate. We have tried to make report questions easy to understand and answer..

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