THE BOOK




Table of Contents

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Personal Information Sheet

Name/Naam _____________________________________ Mobile _______________________
Passport # ______________________________________ Visa # _________________________
______________________________________________________________________________
Allergies/Do NOT Give these medications, Allergies/Ausadhi na dinus:  ____________________
______________________________________________________________________________
Medications I take daily, Ma dainik ausadhi khanchu:  __________________________________
______________________________________________________________________________
Meds. I prefer if needed, Abasekta pareyo bhane linchu: ________________________________

In case of emergency: ____________________________________________________________
______________________________________________________________________________
Spouse, Pati/Patni, Son, Chora: ____________________________________________________
Daughter, Chori: ________________________________________________________________
Mother, Ama: __________________________________________________________________
Father, Buba/Bau/Baba: __________________________________________________________
Brother, Dhai/Bhai: ______________________________________________________________
Sister, Didi/Bhahini: _____________________________________________________________
Friends, Sathiharu: ______________________________________________________________
______________________________________________________________________________