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Get IL DPA 2390 2001-2024

Ient named above at ______________________________________________________ on ___________________. Location (Name, City) Date The abortion was performed because: (Circle one code only) Surgical The abortion was necessary due to a physical disorder, injury, or illness, including a life-endangering physical condition caused by or arising from the pregnancy itself, that would place the woman in danger of death unless an abortion is performed. W7452 W7576 The recipient reported tha.

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