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Get Ca Vs 85 2016

AL REGISTRATION NUMBER TYPE OR PRINT CLEARLY IN BLACK INK ONLY – THIS FORM BECOMES THE OFFICIAL BIRTH RECORD 1A. NAME OF CHILD—FIRST 1B. MIDDLE 1C. LAST I FACTS OF BIRTH 2. SEX I 3. DATE OF BIRTH—MM/DD/CCYY 4. NAME OF PHYSICIAN (OR ATTENDANT, CERTIFIER, OR OTHER PERSON ATTENDING THIS BIRTH) I 5A. PLACE OF BIRTH—HOSPITAL, STREET, NUMBER, LOCATION 5B. CITY OR TOWN 5C. COUNTY 6A. NAME OF PARENT—FIRST 6B. MIDDLE 6C. LAST (BIRTH) 6D.RELATIONSHIP  MOTHER  FATHER  PARE.

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