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Get Oha Form 2016-2024

R unused marijuana. Only one individual can be authorized per form. Section 1 — Patient authorizing transfer Name: Phone number: OMMP card number: OMMP card expiration date: Section 2 — Person authorized to make transfer Name: Phone number: OMMP card number: OMMP card expiration date: My caregiver grower is authorized to transfer (check all that apply): usable marijuana immature plants seeds Section 3 — Signature (required) I,___________________________, authorize my excess .

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