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(Rev 2/11) Commonwealth OF PENNSYLVANIA DEPARTMENT OF HEALTH PRIVATE PHYSICIAN S REPORT of PHYSICAL EXAMINATION of a SCHOOL AGE CHILD New Hope-Solebury School District Grade Date Name of Child Date
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Physical form - new is a document used to gather information about a person's physical health and condition.
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Physical form - new must include information such as height, weight, blood pressure, medical history, and any current health conditions.
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