English - 3977-84e - Health Care Provider...
Dataset description:
Form created with public health. Eligible uninsured patients diagnosed/treated for TB, physicians submit form to get paid
Source: Health Care Provider Claim - Diagnostic and Treatment Services
Additional Information
| Last updated | September 11, 2023 |
|---|---|
| Created | December 11, 2021 |
| Format | application/pdf |
| Form Number | https://forms.mgcs.gov.on.ca/dataset/62efdebb-02eb-41b5-be8a-e31c38d4c3af/resource/6db4c027-e0ea-4a77-aa10-a67553dc7d01/download/3977-84e.pdf |
| Form File Identifier | 3977-84e |
| Name | English - 3977-84e - Health Care Provider Claim - Diagnostic and Treatment Services |
| Form File Status | Available |
| Description | |
| Language | English |
| Functionality | Fill and Print |
| Form File Content Type | Form |
| Remark | |
| Edition Date | 2023-06 |