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["Immune",null,"Allergy",null,"0 mm"]
["Non immune",null,"Medical",null,"< 5 mm"]
["N/A",null,"Religious",null,"< 10 mm"]
[null,null,"Undeclared",null,"> 10 mm"]
[null,null,"N/A"]
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["DO NOT CHANGE ANY DATA IN THIS WORKSHEET.  CHANGES WILL EFFECT FUNCTION OF EMPLOYEE HEALTH RECORD"]