Medical File Information

[Lacey Carterro]

It is required that all staff members and students of Hogwarts must fill out a form so that I have a record of your medical history.

[center][img]100 x 100 image here[/img]
[size=3][b]First, Middle, Last name here[/b][/size][/center][b]Age:[/b]
[b]Date of Birth:[/b]
[b]Occupation:[/b] [i](If professor, state your job. If Student, state your house and year)[/i]
[b]Allergies:[/b]
[b]Medications:[/b]



[Izabella Rivera]

Izabella Marie Rivera

Age: 27
Date of Birth: September 14, 2003
Occupation: Transfiguration Professor and Head of Hufflepuff
Allergies: None
Medications: None

[Cindra Rourke]

Cindra Tae Rourke

Age: 25
Date of Birth: November 11, 2005
Occupation: Arithmancy Professor, Hogwarts
Allergies: Cats
Medications: Antihistamine Potion