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FORMATION AND DO NOT LEAVE SPACES BLANK.  LAST NAME / APELYIDO FIRST NAME / PANGALAN __________________________________________________ ___________________________________________________________ MIDDLE NAME / GITNANG PANGALAN PLACE OF BIRTH / POOK NG KAPANGANAKAN __________________________________________________ ___________________________________________________________ GENDER / KASARIAN DATE OF BIRTH / PETSA NG KAPANGANAKAN (Ex. January 1, 2010) MALE CIVIL STATUS: FEMALE S.

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