Date of Birth: 
Friday, 9 October, 0071
Other information: 
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Gender: 
Girl
School: 
10
Emergency Contact: 
99
Emergency Contact Phone Number: 
72
Parent / Guardian: 
Maxine
74
22
13
Relationship of Emergency Contact to the Child: 
96
School Year: 
10
I agree that my child may receive emergency medical treatment by a trained member of staff or medical practitioner if needed: 
Doctor Address: 
Ayden