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Not have the capacity to understand the information Witness (Not a hospital staff, if present); Name-Surname: Signature: Date: Signature: Date: Signature: Date: Time: Informing Doctor; Name-Surname: Time: Translator (If needed); Name-Surname: Time: Patients older than 18 years by themselves, Patients between 15-18 years both by themselves and by their Legal Guardian, Unconscious Patients, Patients younger than 15 years, patients that are not authorized to make decision.

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