Medical Marijuana Card in San Francisco: How to Get One

41 minute read
Medical Marijuana Card in San Francisco, CA 2024
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Yes. If you are 18 or older, live in California and have a health condition that a physician agrees cannabis may help, you can get a recommendation under the California program without leaving San Francisco. The program is the same in every city of the state, the appointment is held online with a physician licensed in California, and the county ID card from the San Francisco Department of Public Health is free and optional.

The short version

  • One program for the whole state

    San Francisco patients use the California program created by Proposition 215 and the Medical Marijuana Program Act [1][2]. There is no separate city program to join first.

  • A physician makes the call

    A doctor licensed in California reviews your condition and decides whether a recommendation is medically appropriate. Some people are declined, and an honest evaluation allows for that.

  • The recommendation is the document that counts

    Once approved, you receive a signed recommendation as a PDF by email. It is what a licensed retailer checks, and what gives you patient status under state law.

  • The county card is free and optional

    The San Francisco Department of Public Health issues the state ID card (MMIC) in person at 25 Van Ness. It costs nothing, and with it you stop paying sales and use tax on medicinal purchases [3][4].

Prefer to see the whole route first? Jump to the step-by-step guide.

How does California’s medical cannabis program work for San Francisco residents?

California built its medical program in two layers. The first is the Compassionate Use Act, approved by voters as Proposition 215 in 1996. It protects patients, and the people caring for them, who possess or grow cannabis for medical purposes on a physician’s recommendation [1]. The second layer is the Medical Marijuana Program Act, passed as Senate Bill 420. It lists the qualifying conditions, sets the patient limits and creates a voluntary state identification card [2][6].

For someone living in San Francisco, this means everything rests on the recommendation from a physician licensed in California. The state ID card, known as the MMIC, is an extra. Counties run the card locally, and since San Francisco is a city and a county at the same time, one office handles it for every neighborhood from the Sunset to the Bayview: the Medical Marijuana Identification Card Program of the San Francisco Department of Public Health (SFDPH) [3]. The city’s own rules for the card sit in Health Code Article 28 [8].

Age decides the route. From 18, a resident can be evaluated on their own. Between 18 and 20 the adult-use market stays closed, so legal access goes through a recommendation. From 21, the medical program is a choice rather than a requirement.

The law makes room for a primary caregiver as well. In San Francisco, the county card office asks that a caregiver be at least 18, already help the patient with housing, health or safety, and come along when the patient applies. A patient can name one caregiver [3].

A card or recommendation issued in another state is not valid in California. If you moved to San Francisco recently, you need an evaluation by a physician licensed here.

How the state ID card works, and how we help you order it: California MMIC page. Everything about the evaluation itself is on the California medical card page.

San Francisco Office of Cannabis or SFDPH: who does what for patients?

Two city offices have cannabis in their job description, and patients often call the wrong one. One handles your health ID card. The other handles businesses. The state adds a third office that licenses sellers, and your physician is the fourth piece. Pick the task you have in mind to see who to contact.

What do you need to do?

  • Your physician

    A doctor licensed in California evaluates you and, if it is medically appropriate, signs the recommendation. This is the only step that involves a medical decision.

  • SFDPH card program

    The Medical Marijuana Identification Card Program of the Department of Public Health issues the state ID card to San Francisco residents and their caregivers [3].

  • Office of Cannabis

    Permits cannabis businesses in the city, runs the Equity Program and answers questions about enforcement [9]. It does not register patients or issue cards.

  • Department of Cannabis Control

    The state agency that licenses retailers, delivery services and growers across California. Before you buy, you can confirm that a seller holds an active state license [10].

The four cards above are the overview. Pick a task to highlight the office that handles it and open its address, phone and hours right here.

Getting a recommendation

You book an evaluation with a physician licensed in California, and the whole appointment takes place online. No city office is involved in this step, and you do not need to visit one. Start on the California medical card page.

Medical Marijuana Identification Card Program, SFDPH

25 Van Ness, 5th Floor Reception, San Francisco, CA 94102. Phone (628) 754-6432. Applications are taken in person on Tuesday and Thursday, 9:00 am to 12:00 pm and 1:00 pm to 4:00 pm, closed on public holidays. Every visitor signs in at the security desk on the 1st floor before going up [3]. Details on SF.gov.

San Francisco Office of Cannabis

49 South Van Ness, Suite 660, San Francisco, CA 94103. Phone (628) 652-0420, email [email protected]. Help with permits, the Equity Program and enforcement, Monday to Friday from 1 to 5 pm, by appointment only [9]. See SF.gov.

Checking a seller’s state license

Search the business by name or license number in the DCC cannabis license search [10]. A seller you can rely on shows an active state license. Hemp and delta-8 shops are not part of the medical program, whatever their window signs say.

What does the City and County of San Francisco add to the state rules?

The state writes the medical program; the city decides how cannabis fits into its streets and buildings. Three local rules matter to patients. First, a business that sells to adults in San Francisco must also sell medical cannabis, so patients are not limited to a few medical-only stores [11]. Second, the city treats cannabis much like tobacco when it comes to smoking in public and in shared buildings [7][12]. Third, on-site consumption lounges exist, but only with a separate Department of Public Health permit [13]. The details are in the section on where you can legally use medical cannabis.

A medical question about your own case belongs with the physician, not with either city office: California medical card FAQ.

Physician’s recommendation or San Francisco MMIC: which one do you need?

Most patients in San Francisco only ever use the recommendation. The county card adds a tax break and a state ID that is quick to verify. Here is how the two documents compare, row by row.

  • Who issues it

    Recommendation

    A physician licensed in California, after an evaluation

    SFDPH ID card

    SFDPH, under the state MMIC program [3]

  • What you need for it

    Recommendation

    A California photo ID, your medical history and an online appointment

    SFDPH ID card

    • Application form
    • Your physician’s documentation
    • Government photo ID
    • Proof of San Francisco residency, not a P.O. Box [3]
  • Cost and timing

    Recommendation

    Current prices are on the California page; the PDF is emailed once the physician signs

    SFDPH ID card

    Free. About two weeks of processing, then pickup in person [3]

  • What it gives you

    Recommendation

    Patient status under state law, access from age 18 and the patient possession limits [1][6]

    SFDPH ID card

    No sales and use tax on medicinal purchases; the excise tax remains [4]

  • Is it required?

    Recommendation

    Yes. Nothing in the medical program works without it

    SFDPH ID card

    No. The state card is voluntary [2]

Your PDF recommendation works on its own while the county card is being processed. You do not have to wait two weeks to start the treatment your physician recommended.

How much could the MMIC save you on tax?

The saving is exactly the sales and use tax on each medicinal purchase. California’s tax agency confirms that the exemption applies when a qualified patient shows a valid MMIC together with a government photo ID, and that it does not touch the cannabis excise tax [4]. How much that comes to depends on how much you buy and on the local sales tax rate printed on your receipt. Look at that line on your last receipt: that is the amount the card removes. For someone who buys monthly, it adds up over a year; for an occasional buyer, the trip to Van Ness may not be worth it.

How do San Francisco residents apply for the county MMIC?

  1. Get your recommendation first. The county needs your physician’s documentation or a letter about your qualifying condition.
  2. Collect the papers: the completed application form, the physician’s documentation, a government photo ID such as a driver’s license or passport, and proof that you live in San Francisco (a utility bill, a lease, an ID with your address, or a recent rent or mortgage statement) [3].
  3. Go to 25 Van Ness on a Tuesday or Thursday during office hours. Sign in at the security desk on the 1st floor, then go up to the 5th floor reception.
  4. If you have named a caregiver, bring them: they apply together with you.
  5. Come back to pick up the card in person when it is ready, usually after about two weeks [3].

The city’s page does not say how long the card stays valid or how it is renewed. Health Code Article 28 has a section on expiration dates [8], so ask the office about your card’s date when you apply.

Still deciding? Compare both documents in more detail on our MMIC vs recommendation page.

Which conditions qualify for medical cannabis in California?

California names a short list of serious conditions in the law and then leaves room for the physician’s judgment. That second part is why people whose diagnosis is not on the list still receive recommendations.

After the named conditions comes a catch-all. A physician may also recommend cannabis for a long-lasting symptom that seriously limits everyday life (work, sleep, walking, looking after yourself), or one that would put your physical or mental health at risk if nothing relieved it [2].

PTSD, anxiety and insomnia usually fall under that clause. They are common reasons for an evaluation, but the decision is individual: the physician weighs your history, the treatments you have already tried and the medicines you take. A diagnosis listed on this page is never a promise of approval.

What can medical cannabis help with, and where is the evidence strongest?

Research on cannabis for symptoms is uneven, and it helps to know where it is firmer and where it is thin. Pain is where most patients start. In a survey of 2,032 people in a medicinal cannabis program, chronic pain alone accounted for 29.4% of them, and between 41.2% and 59.5% across the pain groups said they had replaced a prescription drug, most often an opioid, with cannabis [14]. Those answers were self-reported, with no control group.

In a UK registry of 82 patients with inflammatory arthritis whose pain had not responded to standard care, starting THC and CBD products was linked with lower pain, better sleep and less anxiety over 12 months [15]. It was an observational study without a placebo group, and side effects were common: 230 adverse events were recorded. For anxiety, PTSD and sleep on their own, the data are thinner still, which is one more reason the decision sits with a physician who knows your history.

Who can get a medical marijuana card in San Francisco, and what do you need?

  • You are 18 or older.
  • You live in California and can show it with a California photo ID.
  • You have a condition or a persistent symptom that a California-licensed physician considers appropriate for cannabis.
  • For the optional county card only: proof that you live in San Francisco [3].

Look up your own condition, with what is known about it, in the conditions library.

How to get a medical marijuana card in San Francisco, step by step

The whole route has five steps. The first four are enough to be a patient; the fifth is optional and the only one that involves a visit in person.

  1. A few minutes

    Check your condition

    Look through the conditions above. If yours is not listed, write down how it affects your sleep, work or daily life: that is exactly what the physician will ask about.

  2. Before the appointment

    Gather what you need

    A California photo ID, a list of your medicines and any notes or records about your condition. The checklist below shows what is still missing.

  3. About 15 minutes

    See a California-licensed physician online

    Filling in the form is a five-minute job, and the appointment itself usually runs around fifteen. You and the physician settle on when it starts, so leave some slack in your day instead of a tight window. Everything happens online; there is nowhere to travel to.

  4. After approval

    Receive your recommendation

    When the physician approves, a signed PDF is emailed to you. Save it on your phone and keep a printed copy next to your ID.

  5. Optional, about two weeks

    Apply for the county ID card

    Take your documents to SFDPH at 25 Van Ness on a Tuesday or Thursday. The card is free, and you pick it up in person when it is ready (SF.gov card page) [3].

After that, your medicine comes from a seller holding a state license, which you can confirm in the DCC license search [10].

Your condition, a photo ID and a quiet quarter of an hour are what it takes to begin.

Get your California medical card

What do you already have for the appointment?

Before you book, check what is already in hand. Pick the line that describes you and tap the items you have. The summary shows what is still missing and why it matters. Nothing you choose here leaves this page.

Where are you starting from?

Your situation changes the note on the right, not the list itself.

What do you already have?

The last item is only for the free county card, so it does not count toward being ready for the appointment. Where to get each item is explained in the summary.

Ready for the appointment

–of 4

Choose your situation and tick what you have.

    When the list is complete: get your California medical card.

    “420 evaluation” is the everyday name for a medical cannabis evaluation. The number comes from cannabis culture, not from medicine; the appointment itself is an ordinary medical consultation.

    Searching for a 420 doctor in San Francisco leads to the same thing: an appointment in which a physician licensed in California reviews your symptoms, history and medicines, and decides whether cannabis is medically appropriate for you. A recommendation is not a product on a shelf. It is a clinical decision, and the physician can say no.

    Is it legal to do this online? Yes. California law lets licensed physicians care for patients through telehealth, the same way they would in an exam room, and holds them to the same standard of care [16]. That is the only practical difference you will notice: you speak with the physician from home rather than from a waiting room.

    What the physician usually asks about:

    • your main symptoms, how long they have lasted and how they affect daily life;
    • treatments you have tried and how they worked;
    • medicines and supplements you take, and alcohol;
    • mental health history, pregnancy, and whether your job is safety-sensitive.

    If the physician decides cannabis is not right for you, you do not receive a recommendation. What happens to the payment in that case is explained in the California FAQ.

    Managing a chronic condition in San Francisco and tired of the runaround?

    Many people with long-running pain, anxiety or poor sleep put this step off for months. Not because they doubt it, but because the old route sounded like a part-time job. It used to look like the left column. It looks like the right one now.

    Then

    • Ask your regular doctor for a referral
    • Wait for a specialist appointment
    • Travel across town to the office
    • Sit in a waiting room, then fill in paper forms

    Now

    • Fill in a short online form
    • Talk one to one with a California-licensed physician from home
    • Receive the signed PDF by email if approved

    Patients mostly like the change. In a survey of 252 people who used a hospital telehealth clinic, 86% were satisfied and 65.5% felt the virtual visit gave them enough to replace an in-person one [17]. That clinic was in Saudi Arabia during the pandemic and only 18% of patients answered, so treat the number as a signal, not a rule.

    How do you check a medical marijuana doctor’s California license?

    Whoever evaluates you must hold an active California license, and you can confirm that yourself in a few minutes with public tools. It is worth doing with any service, ours included.

    • California license lookup

      Medical doctors (MD) are licensed by the Medical Board of California; osteopathic physicians (DO) by the Osteopathic Medical Board of California. Both appear in the state’s license search. Enter the physician’s name or license number and look for an active status [18].

      Open the state license search
    • National provider number

      Every U.S. clinician who bills for care has a National Provider Identifier (NPI). The NPPES NPI Registry shows the name, type of practice and state behind the number [19].

      Open the NPI Registry

    Red flags in any evaluation service

    • Approval is promised before anyone has looked at your history.
    • Nobody can tell you the physician’s name or license number.
    • There is no conversation with a physician at all, only a form.
    • You are pushed to decide today or to buy extras you did not ask about.

    With us, every appointment is one to one with a physician who holds a license in California, and the decision is theirs alone. You can see who our physicians are on the doctors page.

    4.6out of 5 on Google

    Across 250 reviews from patients in the states where we are licensed. We do not sort them by score and do not hide the low ones.

    • 150,000+patients evaluated – everyone who has been through an appointment with us, in every state where we are licensed
    • Since 2017doing only this: online evaluations for medical cannabis programs, and nothing else on the side

    Is medical cannabis safe? Forms, side effects and interactions

    Cannabis is not one product. How it enters the body changes what it does to your airways, how fast it acts and how long it lasts. What stays the same across every form is the effect of THC itself, the chance of interactions with other medicines and the risk behind the wheel. THC and CBD also behave differently, so the risks of one should not be read onto a product that contains only the other.

    Inhaled: smoking dried flower, or vaporizing flower or oil

    What it avoids
    The long delay of forms that are swallowed.
    What stays
    Smoke is a product of burning plant material, and vapor is a hot aerosol on the same airways. Cannabis smoke can harm lung tissue [20].
    Timing
    Acts sooner and wears off sooner than forms taken by mouth.

    Swallowed: capsules, edibles, oils taken by mouth

    What it avoids
    Smoke and hot vapor on the airways.
    What stays
    It passes through the liver before reaching the blood. THC effects, interactions and drowsiness remain.
    Timing
    Effects can take from 30 minutes to 2 hours to appear [21] and last longer.

    Under the tongue: tinctures, oils, oral sprays

    What it avoids
    Smoke and vapor.
    What stays
    THC effects, interactions with medicines and drowsiness.
    Timing
    Measured by drops, which makes small, repeatable amounts possible. How to start is a question for the physician.

    On the skin: creams, balms, transdermal patches

    What it avoids
    The airways entirely.
    What stays
    Creams act where they are applied. Patches are designed to carry cannabinoids into the bloodstream, so they behave more like a medicine taken internally.
    Timing
    Depends on the product; follow the plan you agree with the physician.

    Applies to every form

    • THC can affect memory, attention and coordination, slow reaction time and raise heart rate [20].
    • Medicines and alcohol taken at the same time change how strong the effect is [21].
    • Drowsiness adds up with sleep aids, sedatives and some pain medicines; tell the physician everything you take.
    • Do not drive after using cannabis in any form [20].

    Watch out: delayed effect

    Forms you swallow can take 30 minutes to 2 hours to act. Taking a second portion because the first “did nothing” is a common way people end up with too much [21].

    Prescription medicines made from or modeled on cannabinoids are a separate category. Epidiolex (purified CBD for certain seizure disorders) and Marinol or Syndros (dronabinol, for appetite loss with weight loss in people with AIDS) are FDA-approved drugs filled at a pharmacy with a prescription, not products bought with a medical card [22].

    Form, starting amount and timing are decided with the physician during the appointment. This page does not suggest doses.

    How physicians think about amounts in general is covered in our article on dosing medical cannabis.

    Where can you legally use medical cannabis in San Francisco?

    A recommendation protects possession and use, not use anywhere. San Francisco’s rules follow its tobacco rules closely: generally, where you cannot smoke tobacco, you cannot smoke or vape cannabis either [7]. Pick a place to see the answer.

    Pick a place

    Choose a place above. The answer and its source appear here.

    At home

    Only if the owner allows it

    You can use cannabis in a private home if the owner allows it. Growing at home (up to 6 plants, out of public view) also needs the property owner’s approval [7]. Renters should read the lease first.

    Shared areas of my building

    Not allowed to smoke

    Smoking is prohibited in enclosed common areas of multi-unit housing, including apartment buildings and residential hotels [12]. The same applies to most indoor places: workplaces, restaurants, bars and entertainment venues [7].

    Street or park

    Not allowed

    No smoking, eating, vaping or other use in public places such as parks and sidewalks, near schools or anywhere children are present [7].

    Public event

    Not allowed

    Outdoor public events such as music festivals, street fairs and parades are off limits for cannabis use [7].

    Licensed lounge

    Allowed

    Consumption lounges operate with a permit from the Department of Public Health under Health Code Article 8A. Type A lounges serve pre-packaged products, Type B allow some on-site preparation, and Type C allow smoking or vaping [13]. Smoking on the premises of a licensed retailer is allowed only within the limits of Health Code Section 1009.23 [12].

    Presidio or other federal land

    Not allowed

    The Presidio, Alcatraz and the Golden Gate National Recreation Area sites along the shore, such as Ocean Beach, Lands End, Crissy Field and Fort Mason, are national park land where federal law and federal park rules apply [23]. Cannabis is still illegal under federal law, and a state recommendation does not change that.

    In a car

    Not allowed

    Do not use cannabis in a vehicle, and do not drive after using it: driving under the influence of drugs is an offense under the California Vehicle Code [24]. Keep products sealed and out of reach while you drive.

    What happens after the appointment, and how do renewals work?

    What happens after your visit, and what does it cost?

    You get an email once the physician has decided. If you are approved, the signed recommendation is attached as a PDF and can be used right away. If not, the terms for that case are in the California FAQ.

    Prices and card formats (digital, paper or plastic) are listed on the California medical card page.

    How long is a California recommendation valid, and how do you renew it?

    A recommendation is not open-ended: the physician writes the expiration date on it. Renewal is another evaluation, also online, and it is easiest to start a few weeks before that date. See renewing in California.

    If you hold the county card, ask SFDPH about updating it once the new recommendation is signed (SF.gov card page).

    Medical marijuana card in San Francisco: FAQ

    Do you need a weed card in San Francisco if you’re 21 or older?

    No. Adults 21 and older can buy from licensed retailers with a photo ID [5]. A recommendation still matters if you are 18 to 20, need more than the adult limits, or want the sales and use tax exemption that comes with the county card [4]. The comparison is in the legal status section.

    Can I get a medical marijuana card online in San Francisco?

    The recommendation, yes: the evaluation with a California-licensed physician happens online, so there is no office to find near you. The county ID card is different. SFDPH takes those applications in person at 25 Van Ness (SF.gov card page) [3].

    Can I get a recommendation for PTSD or anxiety?

    Neither is named in the state list, but both can fall under the clause for chronic symptoms that limit daily life [2]. The physician decides after hearing your history. More on our PTSD and anxiety pages.

    Does a card from another state work in San Francisco?

    No. The California program relies on a recommendation from a physician licensed in California. New residents need a new evaluation here. For the other direction, see which states accept out-of-state cards.

    Is a DOT medical card the same as a medical marijuana card?

    No. A DOT medical card certifies that a commercial driver is fit to drive. A cannabis recommendation does not excuse a positive test under DOT rules [27].

    Can I use my recommendation before the county card is ready?

    Yes. The recommendation is the core document, and the county card is voluntary [2]. The card only matters if you want to stop paying sales and use tax on medicinal purchases [4].

    More questions answered for California patients: California medical card FAQ.

    Your next step toward a medical card in San Francisco

    1. Check that your age and condition fit the California program.
    2. Book an online evaluation with a physician licensed in California.
    3. Keep the PDF with your ID, and add the free county card later if the tax exemption matters to you.

    The physician decides on medical grounds, and the appointment does not replace care from your regular doctor.

    Get your California medical card

    New to us? See how the service works.

    Elsewhere in California

    This article is for information only. Approval is decided by the physician at your appointment, and the county ID card is issued by SFDPH under the state program. Every rule above links to the office or law it comes from; the full list follows.

    References

    28 sources
    1. 1. California Legislative Information. Health and Safety Code §11362.5 (Compassionate Use Act). 2026.
    2. 2. California Legislative Information. Health and Safety Code §11362.7. 2026.
    3. 3. City and County of San Francisco. Get a Medical Marijuana Identification Card. 2026.
    4. 4. California Department of Tax and Fee Administration. Tax Guide for Cannabis Businesses: Retailers. 2026.
    5. 5. California Legislative Information. Health and Safety Code §11362.1. 2026.
    6. 6. California Legislative Information. Health and Safety Code §11362.77. 2026.
    7. 7. City and County of San Francisco. Know your rights as a cannabis consumer. 2026.
    8. 8. San Francisco Health Code. Article 28: Medical Cannabis User and Primary Caregiver Identification Cards. 2026.
    9. 9. City and County of San Francisco. Get help from Office of Cannabis. 2026.
    10. 10. California Department of Cannabis Control. Cannabis license search. 2026.
    11. 11. San Francisco Office of Cannabis. Cannabis business permit types. 2026.
    12. 12. San Francisco Health Code. Article 19F, Sec. 1009.22. 2026.
    13. 13. City and County of San Francisco. Get a permit to open a cannabis lounge. 2026.
    14. 14. Baron EP, Lucas P, Eades J, et al. Patterns of medicinal cannabis use, strain analysis, and substitution effect among patients with migraine, headache, arthritis, and chronic pain in a medicinal cannabis cohort. J Headache Pain · 2018 · survey DOI: 10.1186/s10194-018-0862-2 PMID: 29797104
    15. 15. Francis A, Erridge S, Holvey C, et al. Assessment of clinical outcomes in patients with inflammatory arthritis: analysis from the UK Medical Cannabis Registry. Int Clin Psychopharmacol · 2025 · cohort DOI: 10.1097/YIC.0000000000000556 PMID: 38976497
    16. 16. California Legislative Information. Business and Professions Code §2290.5 (telehealth). 2026.
    17. 17. AlRadini FA, Abdulrahim M, AlOtaibi N, et al. Patients’ experience of telehealth clinics during the COVID-19 pandemic: Cross-sectional study. Medicine (Baltimore) · 2024 · cross_sectional DOI: 10.1097/MD.0000000000039837 PMID: 39312309
    18. 18. California Department of Consumer Affairs. License search. 2026.
    19. 19. Centers for Medicare & Medicaid Services. NPPES NPI Registry. 2026.
    20. 20. Centers for Disease Control and Prevention. Cannabis health effects. 2026.
    21. 21. Centers for Disease Control and Prevention. Cannabis and poisoning. 2026.
    22. 22. U.S. Food and Drug Administration. FDA regulation of cannabis and cannabis-derived products. 2026.
    23. 23. National Park Service. Golden Gate National Recreation Area: laws and policies. 2026.
    24. 24. California Legislative Information. Vehicle Code §23152. 2026.
    25. 25. California Legislative Information. Government Code §12954 (AB 2188). 2026.
    26. 26. Office of the Law Revision Counsel. 18 U.S. Code §922. 2026.
    27. 27. U.S. Department of Transportation. DOT medical marijuana notice. 2026.
    28. 28. California Legislative Information. Civil Code §56.10 (Confidentiality of Medical Information Act). 2026.

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    I was lucky that I was born in San Francisco, where it is easiest to get an MMJ card. It seems to me that in other states it is longer and the requirements there are more … anyway, thanks to Dr Weedy for the excellent service!

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