Dell Seton Medical Center Medical Records Fax Numberx Raw Imagea3f6f48054c02da5fcedc1033a17848b382610f9146740643ea64ef661595ab1x Raw Image55a19ae5bd8268df76b0f47c3df2f548896eef51b9167a89c0c047bc70c2fa21x Raw Image55a19ae5bd8268df76b0f47c3df2f548896eef51b9167a89c0c047bc70c2fa21x Raw Imagec63f2d8eeccb20b0618172f8782c6601e1e7db79004a280213aa4cd40a89a0f0
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Dell Seton Medical Center Medical Records Fax Numberx Raw Imagea3f6f48054c02da5fcedc1033a17848b382610f9146740643ea64ef661595ab1x Raw Image55a19ae5bd8268df76b0f47c3df2f548896eef51b9167a89c0c047bc70c2fa21x Raw Image55a19ae5bd8268df76b0f47c3df2f548896eef51b9167a89c0c047bc70c2fa21x Raw Imagec63f2d8eeccb20b0618172f8782c6601e1e7db79004a280213aa4cd40a89a0f0
AUTHORIZATION: I give permission to use and release to Recipient Name:. Hospital Directory.
Dell Seton Medical Center at the University of Texas - Healthcare Snapshots
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Dell Seton Medical Center Medical Records Fax Numberx Raw Imagea3f6f48054c02da5fcedc1033a17848b382610f9146740643ea64ef661595ab1x Raw Image55a19ae5bd8268df76b0f47c3df2f548896eef51b9167a89c0c047bc70c2fa21x Raw Image55a19ae5bd8268df76b0f47c3df2f548896eef51b9167a89c0c047bc70c2fa21x Raw Imagec63f2d8eeccb20b0618172f8782c6601e1e7db79004a280213aa4cd40a89a0f0
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Hospital Directory
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MEDICAL RECORDS RELEASE Pa�ent Name: DOB: I authorize the following custodian/en�ty to release the requested Medical Recor
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New Womack Army Medical Center commander on healthcare at Bragg
AUTHORIZATION: I give permission to use and release to Recipient Name: