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The Wellness Centre
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Westshore Medical Centre, Cocorite
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Trinidad & Tobago
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Tel: 622-9355 Fax: 622-3289
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To:
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Re:
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Age:
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Phone:
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Ref:
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Dr.
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Phone:
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Please do the following
tests on this client and charge to our account.
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Results should be
delivered/faxed to the address above
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TSH
Thyroid Profile
HIV
Blood group
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Other:
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done
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