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If you do not know an answer please write don t know or DK in the space provided. If necessary please add a page with additional information. Thank you Pregnancy History Age of biological mother at the time of the pregnancy During the pregnancy did the child s biological mother have any exposure to Recreational Drugs No Yes please specify Alcohol Medications Cigarettes X-rays Chemicals Infections/Rashes High Fever Bleeding Duration of Pregnancy weeks Were there any complications during the...
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