Epstein Secrets

- NOW" ON ELECTIONS OFFICE IMMEDIATELY W ANY aontanost ON nes CARDS INCORRECT. ROYAL PA RIMISTRATION NVN lufludhanIA.All Lill IhAhA.ha.li The Sunshine State ROYAL. ax nn °COPS F 6-06 0E-10-01 gill/ wejciM 00-00-00 if-Sit 0 iNft#M111. %Ong OpetetOn el • MOP% WitiOr• COnarseei ciniewl ID Or, te

ALTH HISTORY (Serious Illnesses Inures explain) (attach narrative it additonal space needed) C. I ARARATARY Ina inelinlaelli e Tuberculin test Sickle Cell type date result NAME: TITLE: ADDRESS: (Please Print) r-rdl- OH 3040. 10116 (lieplooli 14R5-14 Form 3040 which easy be used) Mock Plumbot. 5

e .aplicación nacional. Rapò FCAT (Hattian Creole) Yo prepara rapa apa pou egzamen lekti ak matematik, syans ak redaksyon FCAT bay swivan prensip Sunshine State Standards yo. Yo ekri yon rapa apa tou pou lekti ak matematik pou "modél egzamen ofisyél FCAT itilize pou fé evalyasyon" an. Rapb egzamen oflsyél

n) (attach narrative d additional space needed) C. LABORATORY (as indicated) t- rnoglcbin/Hemafocrit Stool (O & Tuberculin test: LP 1C1 Sickle Cell d NAME: TITLE: ADDRESS: (Please Print) 1 7A /7 5 OH 3040. 10/16 (Rapacas HRS-ef Form 3040 when may 0* oseie) (Stock Nwnbsr 57444430 JU0 2)

sted NR =Not Reported NA= Data Not Available Data Run Date: 05/09/2003 0175242 EFTA01710242 FCAT Reports aparate reports are produced for the Sunshine State :andards tests in FCAT Reading and Mathematics, since, and Writing. A separate report is also printed r the norm-referenced tests in Reading and

Illnesses Injuries: explain) (attach narrative it additional space needed) C. LABORATORY Hemoglobin/Hematocrit Stool 1O & P) Tuberculin test: Sickle Cell Lead Authorized Signature OH 3040. 10190 (Replaces NRS-li Form 3040 which may be used) (Slack Number 5741-000-3040-2) EFTA01710221 ERs Studen