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DINGS AND DECISION PART I: GENERAL INFORMATION Requestor s Name and Address: MFDR Tracking #: M4-06-7024-01 DWC Claim #: Texas Health 5445 La Sierra Drive, #204 Dallas, Texas 75231 Injured Employee: Respondent Name and Box #: Date of Injury: Employer Name: Sentry Insurance c/o Flahive, Ogden & Latson Box #19 Insurance Carrier #: PART II: REQUESTOR S POSITION SUMMARY AND PRINCIPLE DOCUMENTATION Requestor s Position Summary dated 07/06/2006 states in part Enclosed are copies of.

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