taple back of Special Characteristics Card 5.Registration Forms - most recent on top 6.Cumulative Health Record- Immunizations, E Certificate and Physical Examination staple( side 7.Other legal information, such as court order, davits and correspondence from comm. agencies 8.Standardized Test Data Card 9.Stat

back of Special Characteristics Card 5.Registration Forms - most recent on top 6.Cumulative Health Record - Immunizations. Birth Certificate and Physical Examination stapled in- side 7.Other legal information, such as court order, affi- davits and correspondence from community agencies 8.Standardized Test Data

ic Condition 0 Respiratory Illness 0 it Seizure Disorder 0_ Skin Disorder 0 Vl Vision Disorder 0 III Other (Specify) 0 Sof Report of Physical Examination Normal Abnormal If Abnormal, Explain • Height (inches) V • • Weight (pounds) V • Pulse ( ) I.Vr • Blood Pressure l/ • Hair/Scalp ve- •

ovide documentation of the items checked below. YOUR CHILD HAY NOT ATTEND SCHOOL UNTIL THIS INFORMATION HAS BEEN PROVIDED. 1. T.B. Test 2. Physical Examination 3. Hepatitis B 4. DPT/ OT 5. Polio 6. MMR - 1st , 2nd 3rd . For the safety and protection of your child and the school system, sc