|Classification / Identification:|
| ||Form Number:||014-1265-84||Edition date: ||2005/03 |
| ||Title:||Health Number Release|
| ||Ministry:||Health|| || |
| ||Branch/ABC:||Claim Services Branch|| || |
| ||Program:||Claims Services|| || |
| ||Purpose of Form:||Hospitals submit form to ministry to obtain Health Number of patient when number is not available|| || |
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