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Get Ethiopian PS-05-29A 1971-2024

E of birth of the baby is (6) Date (7) Signed (8) Physician 1. Passenger's name 2. Date of Examination 3. Originating Point 4. Destined Point 5. Date of travel 6. Date of birth estimated 7. Date certificate issued 8. Signature of Physician FORM PS-05-29A (901-1361) (Rev. 4/71) Original : Local file Duplicate : Captain of flight Triplicate : Passenger Print .

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