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NeighborhoodAcupuncturePlace 290StonegateRdAlgonquinIL60102 815.893.9825 www.CLnap.com Health History Questionnaire and RegistrationPATIENT INFORMATIONCONTACT Informational Address Primary phone City
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Next, indicate your birth date by writing it in the format dd/mm/yyyy or mm/dd/yyyy, depending on the regional standard.
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Name - Birthways is a form used to report information about a person's birth.
Parents or legal guardians of the child are required to file Name - Birthways form.
Name - Birthways form can be filled out online or submitted in person at the relevant authority.
The purpose of Name - Birthways is to record and maintain accurate information about a person's birth.
Name, date of birth, place of birth, parents' names, and other relevant information must be reported on Name - Birthways.
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