For each admission, the applicant should list the dates,
diagnoses, duration, treatment, name of the attending physician, and complete address of
the hospital or clinic. If previously reported, the applicant may enter "PREVIOUSLY
REPORTED, NO CHANGE." A history of hospitalization does not disqualify an applicant,
although the medical condition that resulted in hospitalization may.
List any hospitalization(s)
not already reported in the APPLICANT EXPLANATION box in relation to items 18a-y.
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