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! “ & Name: #$ $ % $ % Date of Birth: Gender: M F Grade: () * Sickle Cell Screen: Positive Negative NA PPD: Positive Negative NA Immunizations given since last Health Appraisal: Elevated Lead: Yes

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Download the NorFormRN health certificate template from a reliable source.

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Fill in the personal information section, including your full name, date of birth, and contact information.

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A health certificate is a document stating that an individual is healthy and can be used for various purposes such as travel or employment.

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