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Stat 5411 Fall 2012 Exam 2 For some questions you may leave answers as unsimplified numerical expressions The expressions could include mathematical notation such as x0C2F Log 10 45 10. Partner Parents Other children Doula Other present before ANDOR during labor During labor Id like Music played I will provide The lights dimmed The room as quiet as possible As few interruptions as possible As few vaginal exams as possible Hospital REPAIR FORM Company Name If Applicable First Name Last Name Address street address preferred City City State Zip Code Country Telephone Email Address Items being repaired Item Item Descripti e Master 1 Master A Utility Security Master etc You may refer to the lock report provided to your department by Lock Key Services for the correct key designation Building PLEASE DO NOT WRITE IN THIS SPACE Department Authorization Signature Departm 3353 Proposed Regulatory Class Class 11 Product Codes 87MEH S7LZO S7LWJ 87KWZ 87KWY S7KWL 87JD1 87LPH For Information contact Valerie Giambanco Regulatory Affairs Specialist Howmedica Osteonics Corp 325 Corporate Drive Mahwah NJ 07430 Phone 201 83162 S citizen Yes No If you answered Yes to the question above please respond to the following two questions If your answer was No skip to the following section Are you HispanicLatino Yes No Indicate your race by choosing American Indian or Alaska Native Last name First name Middle initial Curre nt Address Permanent Address if different from the current address Message Phone Alternate Phone mail Social Security Number New Application Reapplication For training to begin Fall Semester indic ate year A 4. Appropriation of money for services, and limits on appropriations in aid (a) the Consolidated Fund Act 2007, with effect** from the date of that Act; and (b) this Act, with immediate effect.** * I tudent Entry Form ____________________________________________________________________________________________________________ STUDENT NAME: __________________________________________ ______ ______ G REPRINT PERMISSION REQUEST TO: __________________________________________ ____________ requested) __________________________________________ FROM: __________________________________________ __ HECKLISTREASExecutiveOfficer,IpswichCityCouncil UseOnly No:______________ Rcd:____/____/____Officer:__________________________________________ madeapplicationthedevelopmentapplicationreducesinstancesw 4 4 4 4 4 4 4 4 _______________Time: Reporting date: ______________________Time: ________________Council/BSA location: Reporting person: __________________________________________ Leader Parent Oth name="example.Team"las;&#xs-60;table="teams" name="id"column="team_id"type="long"&#xid-6;unsaved-value="null" &#xgene;&#xrato;&#xr-60;class="hilo"/ name="name"column="team_name"type="string" le Work Number (of authorized person) (______) _________________________ Research student Affiliation mentioned on Manuscritp: __________________________