Child Identification Information 

 

Full Name: (First, Middle, Last): _________________________________________________________

Address: _____________________________________________________________________________

Date Of Birth: ____________________   Place Of Birth : ____________________

Social Security Number : _______________________  Sex: __________

Race: __________  Height: __________  Weight: __________    Hair: _________  Eyes: __________

Skin Tone: ________________________      Blood Type:________________

Scars, Marks, Tattoos, Other Characteristics: _____________________________________________

_____________________________________________________________________________________

Doctors Name, Address, Phone Number: _________________________________________________

______________________________________________________________________________________

Dentist Name, Address, Phone Number: __________________________________________________

______________________________________________________________________________________

 

 

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