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For Your Hospital Stay - UCSF Medical Center

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20<br />

Appointment Card<br />

List information about your follow-up appointments on this form<br />

before you are discharged.<br />

Name<br />

Date<br />

Department<br />

Time<br />

MD<br />

Phone<br />

Location<br />

Date<br />

Department<br />

Time<br />

MD<br />

Phone<br />

Location<br />

Date<br />

Department<br />

Time<br />

MD<br />

Phone<br />

Location

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