Prepare the claim for this case by completing the appropriate fields that tabbing through the form works inconsistently; it is recommende information. For the purposes of Connect, all dates

Prepare the claim for this case by completing the appropriate fields that tabbing through the form works inconsistently; it is recommende information. For the purposes of Connect, all dates should be entere field) except for Item Number 24, where the dates should be entered NOTES: this medical facility does not use an outside lab; the patient’s have tried to include information you might need from earlier Case St Click on the link below to access the Encounter Form . Encounter Form Information About the Patient : Name : Donald Martone Sex : M Birth Date : 06/24/1951 Marital Status : Single Address : 83 Summit Rd.