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Get Form B Medical Certificate Fin 74

: hogadmin gov.bc.ca Please see the reverse for important information when completing this form. PrOPErTy fOliO numbEr PART A TO BE COMPLETEd BY PHYSICIAN (please type or print clearly) PATiEnT nAmE POsTAl cOdE PATiEnT AddrEss a) What is the nature of the disability? yyyy / mm / dd d) Is remedial therapy available that would signiicantly lessen the disability? c) Is the disability permanent? yEs b) When did this disability occur? nO yEs nO e) In order to manage normal d.

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