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Oculus, LLC Guardian:Date:Name: Address: City, St:Zip:Phone(H):(C):Date of Birth: Occupation:Sex:Vision or Primary Insurance Ins.:#:Insured:DOB:Glasses Bifocals Trifocals Family HistoryRelationship:DOB:Relationship:Phone
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Name birthdate sex male refers to a form or document that captures an individual's name, date of birth, and gender, indicating male.
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