Get the va form 21 8678

TYPE OF APPLIANCE OR NAME OF MEDICATION Artificial leg metal brace wheelchair etc. 7. LOCATION OF VA MEDICAL CENTER WHICH ISSUED THE APPLIANCE OR MEDICATION CERTIFICATION I hereby apply for annual clothing allowance under 38 U.S.C. 1162. I certify that I wear or use a prosthetic or orthopedic appliance described above because of my service-connected disability or that I use a medication for my service-connected...
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va form 21 8678
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