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Patient's Clearance Record A4029 - DA Mobile App

This mobile application is built in compliance with the Army and is used as a patient clearance report. The patient administrator can specify the both military and non-military activity clearances for the patient. The activity clearances include public trust fund, postal service, change of address, insurance and allotments, etc.

  • Lendlease
  • The Cooperative
  • PG&E
  • oxy
  • Red Bull
  • Mirvac

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Take a peek inside the Patient's Clearance Record A4029 - DA Mobile App

Included Features

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Included Fields

Customize to add, remove, or edit any of the fields below.

  • Ico textbox

    PATIENT'S IDENTIFICATION

  • Ico date

    DATE OF DISCHARGE

  • Ico time

    TIME OF DISCHARGE

  • Ico signature

    SIGNATURE

  • Ico date

    DATE

  • Ico dropdown

    Military

  • Ico textbox

    INITIALS*

  • Ico multiline

    If Other, Specify

  • Ico dropdown

    Non-military

  • Ico textbox

    INITIALS*

  • Ico multiline

    If Other, Specify

  • Ico multiline

    REMARKS

  • Ico signature

    SIGNATURE

  • Ico date

    DATE

  • ...and More!

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