兒童姓名：(原中文名) Child's Chinese Name	性別： Sex	生日： DOB
收養(yǎng)時健康狀況： Health Status of Child When Joining Family:
醫(yī)療康復(fù)與撫育計劃施行情況： Rehabilitation and Nurture Process:
目前生長發(fā)育情況: Recent Developmental Status:

組織名稱:                                   填表日期 :

Name of organization:                   Filling date:

(China-ccaa.org October 16, 2006)