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RACTITIONER 22. BIRTH DEFECTS OR OTHER ABNORMALITIES OF DECEDENT AT BIRTH, DESCRIBE: MO 886-3228 (11-06) Cigarettes Cocaine Heroin Marijuana Other 23. ANY FAMILY HISTORY OF SIDS OR OTHER INFANT DEATH? NO YES UNKNOWN IF YES, DESCRIBE DETAILS INCLUDING DATE OF DEATH AND LOCATION OF OCCURRENCE: EVENTS SURROUNDING DEATH 24. PLACE OF FATAL EVENT (E.G., IN CRIB, IN CAR)? 25. DEATH WITNESSED? 26. WHO FOUND CHILD? TIME FOUND NO 27. STATUS OF CHILD WHEN FOUND Dead Un.

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