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Get WI DCF-F-CFS0059 2020-2024

FACILITY AND CHILD INFORMATION Name Child Care Center Name Child Birthdate (mm/dd/yyyy) B. MEDICATION INFORMATION: Medication shall be in the original container and labeled with the child s name. The label shall include dosage and directions for administration. Dates Medication Time Period Time(s) of Day to be How to be Name Medication Dosage Administered Administered From To AM PM AM PM AM PM AM PM Yes No Does the over-the-counter (OTC) medication label indicate th.

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