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Get AZ Boxing And Mixed Martial Arts Commission ADG/BM102 2018-2024

T Name First Name Middle Street Address Date of Birth City State Zip PHYSICAL HISTORY Has applicant had any of the following conditions: Fainting spells Rupture (hernia) Chest pain Shortness of breath Swollen joints Rheumatism Frequent head aches Convulsions (fits) Chronic cough Spitting blood Cerebral hemorrhage or any other serious injury Number of knockouts received Date of last knockout Longest duration of unconsciousness Have you ever been.

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