Dr Cole & Partners


RED & GREEN PRACTICE

Waterside & Blackfield GP Surgery   


Waterside (Hythe) & Blackfield Health Centres

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Address

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Patient 1

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Patient 2

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Patient 3

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Telephone number

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Please check this box to acknowledge that you wish to register with the Red and Green Practice and that this document will be submitted via the Internet.

Is this the first time you have registered with a GP?

Patient 4

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Name

Patient 5

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Name