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U.S. Department of Health and Human Services
Indian Health Manual

Part 4, Chapter 3: Manual Exhibit 4-3.1F.2a

Ambulatory Patient Care, Master Form, HSM 405

FOR A COPY OF THIS EXHIBIT PLEASE CONTACT YOUR AREA DIRECTIVES DELEGATIONS AND CONTROL OFFICER OR
THE MANAGEMENT POLICY INTERNAL CONTROL STAFF AT 301-443-2650