
WELL CHILD Under 1 month Name: Visit Date: / / Language: T: DOB: / / RR: Reason for visit: Male Age: Interpreter used Name: English Other: P: Female H
Well child under 1 month name: visit date: / / language: t: dob: / / rr: reason for visit: male age: interpreter used name: english other: p: female h.c. length: weight: lb. oz. birth weight: lb. oz. growth charts completed well visit allergies:...
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