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1
What is your first name?
2
What is your phone number?
3
What is your birthday?
4
What is today's date?
5
Who is your emergency contact?
6
What is your zip code?
7
What is your marital status?
8
What is your current address?
9
Who lives with you?
10
What is your last name?
11
What is your email address?
12
What is today's date?
