#admit_status# - #Trim(Referral_Name)#
| Referral Name | Source | Patient Name | Payer | Referral Date | Admission | SOC Date |
|---|---|---|---|---|---|---|
|
#R_Contact_Name# |
#SRC# |
|
#Pay_Name# | #DateFormat(M0104_PHYSN_RFRL_DT, "mm/dd/yyyy")# | #DateFormat(M0030_START_CARE_DT, "mm/dd/yyyy")# |