Flagging rows with collections values across multiple rows with duplicates

hi Anonymous 

not sure if i fully get you, try to add a column like:

Column = 
VAR _table =
FILTER(
    SELECTCOLUMNS(
        TableName,
        "Account", TableName[Account],
        "Visit Date", TableName[Visit Date],
        "Dept", TableName[Dept]
    ),
    TableName[Account]=EARLIER(TableName[Account])
        &&TableName[Visit Date]=EARLIER(TableName[Visit Date])
        &&TableName[Dept]=EARLIER(TableName[Dept])
)
VAR condition1 = COUNTROWS(_table) 
VAR condition2 =
COUNTROWS(
    DISTINCT(
        FILTER(
            _table,
            TableName[Include]=EARLIER(TableName[Include])
        )
    )
) 
RETURN
SWITCH(
    TRUE(),
    condition1=2&&condition2=2&&TableName[Include]="N", "Y", 
    condition1=2&&condition2=2&&TableName[Include]="Y", "N", 
    [Include]
)

it worked like: