Birth month definition
Examples of Birth month in a sentence
Signature of Patient or Legal Guardian: Patient Name: Date of Birth: (month) / (date) / (year) I, THE UNDERSIGNED, AUTHORIZE PAYMENT BY THE PROVIDED INSURANCE COMPANY BE MADE DIRECTLY TO STILLPOINT COUNSELING ASSOCIATES AND ANY REPRESENTATVIE FOR ALL BENEFITS, IF ANY, OTHERWISE PAYABLE TO ME FOR ALL SERVICES RENDERED.
Email Address Social Security Number Date of Birth (month | day | year) Percentage Share Relationship to Participant Participant understands that, if no beneficiary survives the Participant, the Participant’s estate will be the sole beneficiary for the Account.
Signature of Patient or Legal Guardian: Patient Name: Date of Birth: (month) / (date) / (year) I, THE UNDERSIGNED, AUTHORIZE PAYMENT BY THE PROVIDED INSURANCE COMPANY BE MADE DIRECTLY TO STILLPOINT COUNSELING ASSOCIATES AND ANY REPRESENTATIVE FOR ALL BENEFITS, IF ANY, OTHERWISE PAYABLE TO ME FOR ALL SERVICES RENDERED.
Birth month and Birth day record higher proportions of disagreements as well as a significant number of both missing fields.