RICT: 0000050 PALM BEACH GRADE LEVEL: 12 PREPARED DATE: 01/ FL STUDENT ID: 591660245X SSN: 59: LEGAL NAME: MAILING PARENT/GUARDIAN (NAME/CODE): TERESE HALL-GOLICK PARENT IMMUNIZATION STATUS: PERMANENT INNUNI:ATI2N VACCINE STATUS, DATE - TYPE DOSE DATE DOSE DATE DTP 1 03/04/1987 2 05/1 4'1". POLIO 1 0