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Get D1216S Treatment Service Voucher For Use By Specialists And Consultant Physicians Only. D1216S

E number, first name, initial and surname. If the file number is not known, include date of birth and address. LSPN required for diagnostic imaging/ 2 Write the Item Number or Description of Service in the space provided. 3 The Condition Treated section should only be completed if the veteran holds a White card for specific conditions, or if the service is an emergency. 4 The 'Treatment Location' section should only be completed if the service is not conducted in rooms. If the servic.

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