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Medical and School Worksheet - Child - The United States Social ...

Social Security Administration. Publication No. 64-112 (formerly SSA-1171) | ICN 474000 | Unit of Issue — PG of 25. January 2018 (Recycle prior editions) Medical and School Worksheet – Child. Produced and published at U.S. taxpayer expense. M. Medicine(s) the child takes, and the doctor’s name if it is a prescribed medication. Name of ...