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C) Immunization Record: Please provide information about your health immunization. A copy
of your immunization record from your pediatrician or family physician may be necessary to
accurately transfer dates to this record.
Vaccine
Diphtheria, Pertussis, & Tetanus, (DPT)
Tetanus or Tetanus-Diphtheria (Td)
Polio
Measles, Mumps, & Rubella (MMR)
Varicella…
https://www.wichita.edu/academics/health_professions/pt/documents/MSAT_physical-2nd.pdf