EMIL ; PARENT GUARDIAN (NAME/CODE): IC CATEGORY: H SEX: F PARENT BIRTH DATE: MEW BIRTH VERIFICATION: 1 BIRTHPLACE: HOLLY D FL 0 ii C m r SBOtbLZO- INO- ANOS VACCINE STATUS. DATE- TYPE DOSE DATE DTP 1 POLIO 1 SIB 1 MIR 1 HEPATITIS D 1 VAS DISEASE 1 IMMUNIZATION STATUS: PERMANENT IMMU