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Grant County Health Department 528 E Main St Suite E John Day, OR 97845 NAME:(Please Print)MALE___FEMALE___OTHER_BIRTH DATE:___MARITAL STATUS: (Circle one)SMDWRACE: (circle one) (1) American Indian/Alaskan
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Obtain an application form from Grant County Health Department.
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The grant county health departmentjohn is a form that needs to be filled out by certain individuals or organizations to report health related information in Grant County.
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