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REQUEST FOR REQUESTING ACTIVITY -Complete Items 1 …

REQUEST FOR REQUESTING ACTIVITY -Complete Items 1 …

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ABSTRACT OF RATING SHEET HEALTH RECORD DENTAL RECORD X-RAY OUTPATIENT DD FORM 877, SEP 67 REPLACES EDITION OF 1 JAN. 60. USAPPC V1.00 WHICH MAY BE USED. Title: DD Form 877, Request for Medical/Dental Records or Information, September 1967 Author: WHS/ESD/IMD Created Date:

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