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Medical History...for Children 11 Years and Under
DS-1622.pdf
Medical History and Examination for Foreign Service
Medical History...for Children 11 Years and Under
OMB: 1405-0068
OMB.report
STATE/AFA
OMB 1405-0068
ICR 201009-1405-003
Medical History...for Children 11 Years and Under
( Supplementary Document )
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 1405-0068 can be found here:
2023-12-17 - No material or nonsubstantive change to a currently approved collection
2023-07-10 - No material or nonsubstantive change to a currently approved collection
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