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BIRTHBIRTHApplication for Certified Copy of Maryland Birth Record Maryland Department of Health Division of Vital RecordsBy my signature below, I state that I am the person I represent myself to be herein, and I affirm that the information submitted on this form is complete and accurate and submitted subject to the criminal penalties set forth at Maryland Code Annotated, HealthGeneral Section 4227. For Issuing Office OnlySignature of person making request: Photo IDDate of Application:
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