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* 1. Enter your last name (comma) first name.

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* 2. Address

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* 3. Enter your date of birth (dd-MMM-yyyy)

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* 4. Medications

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* 5. Allergies

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* 6. Emergency contact name, relationship, phone number

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* 7. Second contact name, relationship, phone number

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* 8. Blood type, medical history, pacemaker, metal, etc.

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* 9. Special instructions (religious, organ donation, DNR, etc.)

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