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STATE OF WEST VIRGINIA

STATE OF WEST VIRGINIA COMBINED MEDICAL POWER OF ATTORNEY AND LIVING WILL Dated: _____, 20_____ I, _____, hereby (Insert your name and address) appoint as my representative to act on my behalf to give, withhold or withdraw informed consent to health care decisions in the event that I am not ...

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  Virginia, States, Power, West, Attorney, Power of attorney, State of west virginia

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