duracten) (62) NAME (Fat middle MG/. fast) IS (03) ADDRESS WNW comber. emelt:par:mint numb00 (64) cry STATE ZIP 000E (S5) CITY STATE 2V CODE RONC4 Palm &ash P1 -a341 (69)RELAO 0 li ef (e.n If school personnel are unable to contact you in caso may we have your permission to call your doctor or emergency