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I-4: I-5: I-6: I-7: I-8: I-9: I-10: I-11: I-12: I-13: I-14: Item Item Item Item Item Item Item Item I-15: I-16: I-17: I-18: I-19: I-20: I-21: I-22: . . . . . . . . . . . . . . .1 The medical record . . . . . . . . . . . . . . . . . . Resident s name and medical record number Month, day, year, time . . . . . . . . . . . . . . . Signatures . . . . . . . . . . . . . . . . . . . . . . . . Initials . . . . . . . . . . . . . . . . . . . . . . . . . . . Rubber stamp signatures . . . . . . . . . .

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