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Primary Care Physician <br /> Name and address as indicated by <br /> the patient or by the Department <br /> In witness whereof, the Contractor and the Department have <br /> executed this agreement in duplicate originals, _one of which is <br /> retained by each of the parties. <br /> Daniel B. Reimer, Health Director Contractor ' <br /> Orange County Health Department Hillsborough Family Practice <br /> Associates, PA <br /> 101 East Corbin Street <br /> Hillsborough, NC 27278 <br /> #1 OP ColpCont Page 3 of 4 <br />