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Child's name*
Date of birth*
Place of Birth*
Baptism details
Immunisation details
Names of parents
Parents dates of death if applicable
Religions, and addresses of parents if still living
Surname of family
Address of relatives or guardians
Address of clergyman
Health history
Size and type of family
Illnesses/ current treatments
Name of family doctor
Sensitivity to drugs
Reasons for admission*
The circumstances of the family*