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Get View & Print The Complete Manual - CHARGE Syndrome Foundation

Time consuming and often bothersome to the patient, would you kindly provide the CONFIDENTIAL pre-admission information below. Please fold, seal and mail this self-addressed postage paid form to us as soon as possible. We want to make sure your stay in our hospital is as pleasant and comfortable as possible. Sincerely yours, LEHIGH VALLEY HOSPITAL MATERNITY ADMISSIONS ONLY PLEASE PRINT Patient Information Approximate Due Date: / / Attending Doctor: Patient s Name:.

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