📄 Extracted Text (168 words)
SOUTHERN TRUST COMPANY
6100 REd Hook QUARTER, B-3
Sr. ThomAs USVI 00802-1348
Fax Transmittal
To: Cindr i DUC/ gltiCA C141,11O
From: 4 AJA., /\<4C2. - Ogniptie-.5
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Date: 5/Ai / 15
Re:
Fax No.:
Biligent Efr61• your information
El‹;:eview )u your request
111‹---
Total Pages (Includes Transmittal Sheet) I I ME...5
Comments:
EFTA01221597
CIRCLE F DUDE RANCH CAMP To Parent/kid Guardians: Complete Ibis Itdroil midAim Thisfonts CAMP
Licensed Medical Professional to child's Isealllframpmoiderfor ming OFFICE
Camper Health Care Recommendations USE ON-
Date will attend r.•.,.. -2 sr hot if- JO
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(FORM B Health-Care Provider)
EFTA01221598
Health Cure Professional must complete This form, sign, date, and CAMP
CIRCLE F DUDE RANCH CAMP OFFICE
vn•ide license numher USE ON-
LY
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EFTA01221599
EFTA01221600
---
_
EFTA01221601
EFTA01221602
EFTA01221603
Health Care Professional must complete thisform, sign, date, and CAMP
CIRCLE F DUDE RANCH CAMP OFFICE
EFTA01221604
EFTA01221605
c.
Other Required Vaccines on Back
EFTA01221606
EFTA01221607
ℹ️ Document Details
SHA-256
c5cbab8e6bbc6b7f26060d47b86a1a80978f4cb4a75a5e9f6a74fddfa599e029
Bates Number
EFTA01221597
Dataset
DataSet-9
Document Type
document
Pages
11
Comments 0