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Medical Examination for Immigrant or Refugee Applicant
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OMB: 1405-0113
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STATE/AFA
OMB 1405-0113
ICR 202503-1405-005
CDC Email
( Supplementary Document )
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 1405-0113 can be found here:
2026-01-08 - Revision of a currently approved collection
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