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Text File  |  1991-04-22  |  384b  |  7 lines

  1. /* Para. 4484: Transfer */
  2.  
  3. I herewith authorize my spouse, if any, or any relative who is
  4. related to me within the third degree to effectuate my transfer
  5. from any hospital or other health care facility in which I may
  6. be receiving care should that facility decline or refuse to 
  7. effectuate the instructions given herein.