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Courtesy Committee Happenings

Please submit the following information about the hospital stay.

Patient’s name:

Hospital:

Department they work:

Any other information you may have would be appreciated.

Please submit the following information about the birth.

Employee’s name:

Department they work:

Hospital name:

Hospital room number:

Hospital city:

Baby’s name:

Baby’s weight: (if known)

Baby’s height: (if known)

Birth date:

 

Please submit the following information about the death.

Name of person who passed away:

Relationship to DSU Faculty or Staff:

Funeral home:

Date and time for funeral:

Date and time for visitation:

 

Please submit the following information about the wedding.

Employee:

Future Spouse’s name:

Wedding date:

Wedding place:

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