DHS-1639, Well Child Exam Early Childhood: 12 Months
WELL CHILD EXAM. EARLY CHILDHOOD: 12 MONTHS ... Non-compliance of licensing rules. Michigan Department of Health and Human Services Well Child Exam Date Patient Name DOB Sex Parent Name Allergies Current Medications Prenatal/Family History Weight Percentile Length Percentile Wt. for length Percentile HC Percentile Temp. Pulse Resp. BP (if risk) ... ................
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