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E AND BELIEF THAT I HAVE NO MEDICAL CONDITION OR PHYSICAL DEFECT WHICH WOULD PREVENT MY PERFORMANCE OF ACTIVE MILITARY SERVICE EXCEPT AS FOLLOWS: YES / NO u If your answer is YES please provide supporting documents or attach them. SIGNATURE OF APPLICANT AHRC FORM 1046-2-E, JAN 2012 DATE SIGNED PREVIOUS EDITIONS ARE OBSOLETE WARNING: Emailing of this information is at the discretion of the applicant and uses the applicant email system. Womack Army Medical Center does NOT assume any liab.

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