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Complete the DEVELOPMENTALLY, DISABLED YES, YES, OTHER, DISABILITY, SPECIFY IN, FOSTER, CARE DAYCARE, GROUP, HOME, OR, INSTITUTION CHILDCARE, CENTER RELATIVES, HOME FOSTER, FAMILY, HOME FAMILY, FRIEND YES, NO RELATIONSHIP, TO, SUSPECT NAME, BIRTHDATE, and SEX fields with any particulars that are asked by the software.

In the NOT, AMR, OF, N T, NED, CN PLACE, OF, INCIDENT DEFINITIONS, AND, INSTRUCTIONS, ON, REVERSE and Page, of area, highlight the relevant details.

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