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Page 1: koptnb.com · C] Has significant loss of psychological, physiological, personal and social adjustment (severe limitations) Remarks: a) In terms of his/her own job. a Yes C] No b)
Page 2: koptnb.com · C] Has significant loss of psychological, physiological, personal and social adjustment (severe limitations) Remarks: a) In terms of his/her own job. a Yes C] No b)

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