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[33,"Mayo//2026"]
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[null,null," AMBULATORIO",null,null,null,null,null,null,null,null,null,null,null,null,"DNI: "]
[null,null," HOSPITAL DE DÍA",null,null,null,null,null,null,null,null,null,null,"Nombre del progenitor o repr. legal:"]
[null,null," INTERNAMIENTO COMPLETO",null,null,null,null,null,null,null,null,null,null,null,null,"DNI:"]
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[null,null," Terapias de grupo",null,null,null,"Precio/sesión: ",null,null,null,"Terapias ocupacionales",null,null,null,"Precio/sesión: ",null,null,null," Consultas endocrino",null,null,null,"Precio/sesión: "]
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[null,null,"Test psicológicos:",null,null,null,null,"Consulta endocrino en ambulatorio:",null,null,null,null,null,null,null,null,null,null,"Firma del Centro: "]
[null,null,"Fecha de la sesión: ",null,null,null,null,"Fecha de la sesión:"]
[null,null,"Número de sesiones (máx.1): ",null,null,null,null,"Número de sesiones (máx.1): "]
[null,null,"Precio/ sesión: ",null,null,null,null,"Precio/ sesión: ",null,null,null,null,null,null,null,null,null,"Firma del estudiante y/o repr. Legal: "]
[null,null,"Medicamentos: "]