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DEPARTMENT OF HEALTH SERVICES Division of Public Health F05280 (Rev. 11/2016)STATE OF WISCONSIN Wis. Stat. 69.21-Page 1 of 2Waushara CountyWISCONSIN DEATH CERTIFICATE APPLICATIONTYPE or PRINT.(for
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What is parent my name is?
Parent of your name
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Parents or legal guardians
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To identify the parent or legal guardian of an individual
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Name, contact information, and relationship to the individual
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