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KLASS:________________________
NAMN:________________________________________________KÖN:________
TITEL:___________________ REG NR: ______________________________
FÖDELSEDATUM:__________________________
FADER:________________________________________________REG_______________________
MODER:________________________________________________REG_______________________
UPPFÖDARE:_____________________________________________________
ÄGARE:________________________________________________________
ADRESS:_______________________________________________________
POSTNR:_________________ POSTADRESS:_____________________
TEL:_____________________ E-MAIL________________________________