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Notes:


Demographics:Names and addresses of the child and his or her parents/legal guardian; location of the child at the time of the report, child’s age, gender, and race;nature and extent of the child’s injuries, maltreatment or neglect; effect of the injury on the child; name of the person or persons you suspect is responsible for the injury,maltreatment or neglect; family composition; where and how the person making the report can be contacted.