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Physical Exam Form Exceptional Family Member Program, Kenner Army Health Clinic 700 24th Street; Fort Gregg Adams, Virginia 23801; P: 8047349130; F: 8047349053Name: ___ DOB:Age:_ Sex’M FPART 1:
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To fill out name, enter your full name using uppercase and lowercase letters.
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To fill out dob (date of birth), enter your birthdate in the format DD/MM/YYYY.
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To fill out age, calculate your current age based on your dob and enter it as a number.
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To fill out sex, select your gender from the options provided (e.g., Male, Female, Other).

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Name, date of birth, age, and sex are identifiers used to identify and categorize individuals.
Anyone who needs to identify or categorize individuals based on their name, date of birth, age, and sex.
Fill out the required fields with the individual's name, date of birth, age, and sex.
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The individual's full name, date of birth, age, and sex must be reported.
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