Fill in the blanks with the correct information.
Then post this by your phone so you can reference it in an emergency.

Police or Fire - 911

I am __________________________________________

I live at ________________________________________
_______________________________________________

My phone number is ______________________________

My birthdate is __________________________________


 

My parents are __________________________________
Mother's work phone number _______________________
Father's work phone number ________________________


 

My brothers and sisters and their birthdates are:

_______________________________ - _______________

_______________________________ - _______________

_______________________________ - _______________


 

Our doctor is _____________________________________
Phone number ____________________________________
Address _________________________________________


 

Names & Phone Numbers of Friends and Neighbors:

_______________________________ - _______________

_______________________________ - _______________