 GENERAL INFORMATION:

 DATE OF INFORMATION:   3/28/96

 CHILD'S NAME: John Quentin Public

 NICKNAMES: JQ, Johnny Q

 ADDRESS: 123 Your Street

 CITY/STATE/ZIP: Anytown OR  97123

 PHONES:  (503) 555 - 1212

 ALTERNATE:  (503) 555 - 1212

 DAD'S NAME: John P. Public

 WORK PHONE:  (503) 555 - 1212

 MOM'S NAME:  Susie Q. Public

 WORK PHONE:  (503) 582 - 1212

 POLICE CONTACT:  Anytown Police Dept.  (503) 555 - 1212

 DESCRIPTION

 AGE:  4  SEX: M   BIRTHDATE: 5/11/91

 HEIGHT: 3'4"  (40 inches)  WEIGHT: 42 lbs  EYE COLOR: blue

 RIGHT/LEFTHANDED:  Rt   BLOOD TYPE: O+   HAIR:  Blonde

 DISTINGUISHING MARKS/FEATURES/SCARS ETC.

 Scar on left index finger, mole on left shoulder.

 GLASSES:  No   ASTHMA:  No   DIABETIC:  No
 ALLERGIES:  Yes     DETAIL ALLERGIES BELOW

 Possible allergy to penicillin. Allergic to bee stings.

 MEDICATIONS (PRESCRIPTION ONLY)

 None


 PERSONAL INFO: (include favorite hangouts, hobbies etc.)

 Loves water, parks and swings. Knows address and phone number.


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