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Official U.S. Citizenship and Immigration Services medical examination form for applicants.

Report of Medical Examination and Vaccination Record form from U.S. Department of Homeland Security, U.S. Citizenship and Immigration Services, showing Part 1 with fields for personal information.

Report of Medical Examination and Vaccination Record form from U.S. Department of Homeland Security, U.S. Citizenship and Immigration Services, showing Part 1 with fields for personal information.

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