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EXPECTED DATE OF BIRTH MM/DD/YYYY 10a. BIRTHPLACE HOSPITAL NAME 10b. CITY OF BIRTH 10c. COUNTY OF BIRTH 9. WARNING This is a governmental document. Texas penal code section 37. 10 specifies penalties for making false entries or providing false information in this document. The registry address Vital Statistics Unit - 1966 P. O. Box 149347 Austin Texas 78714-9347 Toll Free 888 963-7111 Ext. 7782 Fax 512 458-7164 http //www. dshs. state. tx. us/vs/patreg/default.shtm Information in the...
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Warning this is a is a notice or indication of danger or potential harm.
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