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Get NYS DOH CHRC 103 2006-2024

Merican Indian, Eskimo, or Alaskan native U – Of indeterminable race W –Caucasian, Mexican, Puerto Rican, Cuban, Central/South American or other Spanish origin BIRTH COUNTRY/PLACE FIELD Enter United States of America for those of American birth Enter Country of Birth for those not of American birth HEIGHT FIELD To be completed as a three (3) character value. If reported in feet and inches, the first (leftmost) digit is used to show feet with the two rightmost d i aeue t so tei h s ew e 0.

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