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[null,null,null,"SOLICITA"]
[null,null,null,"MAC SAN RAFAEL - PINARES"]
[null,null,null,"IPS CLÍNICA SAN RAFAEL - CUBA"]
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[null,null,null,"TIPO DE IDENTIFICACIÓN "]
[null,null,null,"CÉDULA DE CIUDADANÍA"]
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[null,null,null,"REGISTRO CIVIL"]
[null,null,null,"CARNET DE EXTRANJERÍA "]
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[null,null,null,null," SOCIMÉDICOS S.A.S.   NIT 900342064"]
[null,"AUTORIZACIÓN DE SERVICIOS N°",null,0,null,"FECHA"]
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[null,"DATOS DEL PACIENTE"]
[null,"NOMBRE DEL PACIENTE"]
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[null,"NÚMERO DE IDENTIFICACIÓN ",null,null,null,"EDAD"]
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[null,"SEDE QUE SOLICITA"]
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[null,"PROCEDIMIENTO O INTERVENCIÓN A REALIZAR"]
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[null,"INSTITUCIÓN A LA QUE SE REMITE"]
[null,"ESE HOSPITAL UNIVERSITARIO SAN JORGE DE PEREIRA\nCra 5 # 24-47 Pereira/Risaralda                                       TEL: 3356333"]
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[]
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[null,"SOCIMÉDICOS S.A.S. se hace responsable de cubrir en su totalidad los procedimientos a realizar a cada uno de los pacientes que sean remitidos."]
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[]
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[null,"FIRMA DE QUIEN REMITE"]

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[null,null,null,null,null," SOCIMÉDICOS S.A.S.   NIT 900342064"]
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[null,null,"ESE HOSPITAL UNIVERSITARIO SAN JORGE DE PEREIRA\nCra 5 # 24-47 Pereira/Risaralda                                       TEL: 3356333"]
[]
[]
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[null,null,"SOCIMÉDICOS S.A.S. se hace responsable de cubrir en su totalidad los procedimientos a realizar a cada uno de los pacientes que sean remitidos."]
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[null,null,"FIRMA DE QUIEN REMITE"]

{"sheet":"Hoja1","index":3,"n_rows":7,"n_cols":13,"rows_kept":7,"cut":false,"hidden":true,"merged":[[3,12,4,12],[6,12,7,12],[3,13,7,14],[3,4,7,5],[3,6,4,11],[5,6,7,8],[5,9,7,11]]}
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[null,null,null,null,null,null,"NOMBRE\nAUTORIZACIÓN DE SERVICIOS",null,null,null,null,null,"CÓDIGO\n16-FT-021"]
[]
[null,null,null,null,null,null,"TIPO DE DOCUMENTO\nFORMATO",null,null,"ÁREA RESPONSABLE\nMEJORAMIENTO CONTINUO ",null,null,"VERSIÓN 1"]
[null,null,null,null,null,null,null,null,null,null,null,null,"VIGENCIA\n23-06-2018"]