State form 45877 r3 10 02 bcd 0054-2025

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35 votes

The document is a health care program form for child care centers, specifically the Child Care Center Health Record. It includes sections for recording a child's personal information, medical history, physical examination details, and immunization records. The form aims to ensure that children are healthy and safe in group settings by documenting any health conditions or medications that may affect their participation in activities.

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Versions	Form popularity	Fillable & printable
2019	4.1 Satisfied (31 Votes)
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