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StudentName:Last___ First___ DateofBirth___ RequiredImmunizations Thisformmustbecompleteandsignedbyahealthcareprovider, wewillalsoacceptasignedImmunizationformfromyour healthcare provider\'sElectronicMedicalrecords
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How to fill out date of birth 1

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Start by entering the day of the month you were born in the first box.
02
Next, select the month you were born from the drop-down menu.
03
Finally, enter the year you were born in the last box.

Who needs date of birth 1?

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Individuals filling out official forms or documents such as government applications, job applications, or healthcare forms may need to provide their date of birth.
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Date of birth 1 refers to the first date of birth listed or required on a form.
Individuals who are filling out a form that requests date of birth information are required to provide date of birth 1.
Date of birth 1 should be filled out by entering the month, day, and year of the individual's birth.
The purpose of date of birth 1 is to accurately identify individuals and confirm their age for various purposes.
Date of birth 1 must include the month, day, and year of birth of the individual.
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