What does R/O mean on a medical document?

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It depends on the context in which it was used. It could be rule out,  receive only, removal of....

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What does PSA mean

PSA (medical term) is a test for Prostate-Specific Antigen. A high number indicates probable prostate cancer. PSA (Airline) was Pacific Southwest Airlines, now part of US Airways. There's also another regional carrier named PSA, also part of US Airways.

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An emoticon. Done with the keyboard instead of inserting an image. :o . . OH! Jay

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