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Get HI Form WC-2 2005-2024

Disability began: regular work on: Patient stopped treatment without orders on Patient discharged as cured on Describe any permanent defect or disfigurement (include scars, discolorations, deformities, etc.) None Final Diagnosis: Physician Signature Date Visit our Website at www.hawaii.gov/labor for ALL interactive and downloadable forms. (Rev. 10/05) .

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