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Youthful ImagesPatient Informational Patient Name: FIRST Name you prefer to be called:MIDDLEMOST Social Security #: Address: City: State: Zip: Marital Status: Married Single Date of Birth: Age: Sex:
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How to fill out drilled ass

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Clean the area around the drilled hole with a damp cloth.
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Sand the filled area with fine-grit sandpaper, gradually working your way to a smooth finish.
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