{"text":"SERVICE \u2014 Please Tick As Appropriate \ne M e i e iy \nr | \n| ) \n| | \ni ELDERLY CHILDREN HANDICAPPED OTHER u l \n! \" Residential O Residential [J Residential [ Probation | 3 \n\u00e9 Community Care Unit 0 Foster Care L Day Care O Supervision 0 i \ni Day Care D Community Carer D Home Help D 1 \ni DayCare LJ . e U ? \ni Short Term D Short Term D\/ Short Term D Short Term D | \n! Long Term D Long Term D Long Term D Long Term D : \n; . : ; \n\u00a2 FullName ... COLWY. TAAESOD. SMBERS - vvvee FO e ereteererreear e | \nE Present Address* ! \n| | \n{ i \n. } \no \\ ; \n| . Stawtory Condition Imposed Sl\u2018SS\\J(S>R&8 ....... \u2018 \n3 ; Name of Doctor Nor et Lecisveocss. .. D.OB. .=.... %T[}%\u2018 Al !.QE,[\u2019E}'Q, ..... ! \nb e reeeaeans \\\u201c \\ CaseRef. ... 34O FLQFOleererrrenns | \n| School Attended B eeeefereadMin. \u201c\u201cTo .................... et reaieesieeraraaneaans A \n\u2019 (Children only) . L | \ne ...---..........\\?\u2018........\\.\u201c ..\u2018.:....? ........................................ gy \n{ Date of Change .....\\om.BXCem@e . 1A8R .. N \n: *Including name of Foster Parent\/Community-Carer where_applimbl\u00e9; \n* FOSTERING PAYMENTS\/ COMMLINIFY-CARER-FEES. (Delete) EFFECTIVE DATE \n! Stop . D tessestrranarensree W }'C\" \n' Start LY ..i.(?..).\\.?.].\u2018.'f\".\u2018a? ]\/}\u2018L \\\/ \n1 . \nAmend Register [ t Lt K YM\/( _7_'0} h \n. N \n\"Reason ......... C.O H.E..JD-).%..QAQE.-.\u201d.,.\u2018._t.--).\u2018-\u2019...u'i}........................'... ........... l.-.)\/zg,% \n' Name of FP\/CC ..... MES . L4 LQACE cenn.. v\\r .......................... Crreaneenirane Tes \u2019 \n| RESIDENTIAL CARE\/COMMUNITY: CARE UNIT\/DAY CARE (Delete) \n\\ Admission ' ' ~ \nDischar; \\ \ni Temg. \/ \nReason \no \u2014\u2014\u2014\u2014\u2014- = o A \n\u2014\u2014 s oo \u2014\u2014 o \n. \"rssssasvecsfannannescaransana sesenncavan f'... \u201csevreaerrIsestatruvrrsennssSonsnnn sema sieanana \nEstablishment ... ... .iiiviiiieinnninnnnannas \" \/ ....... feeanneeioann eeesrnareiianaccnigfrecennnens \n5}\u2014 SSZ ' ! i - \nFinancial Ass\u00e9\u00e9sment Attached [ \/ \no \nsumnvrsuyn\u2018omflowno \nAction to befaken ,........., e , \u2018Effccl\u2018ivcbaly\/............ ..... \/ feaaaee \nReasop\u201d vo.ivnvviviie e i e, tesseseiseaanenaboraleanercecarnnnianennn - Cieevse \nAuthorised ... Al itin o\u20ac Lot N Date L L J12 R \n\" OFFICE Action taken ....... Q w} .U.~.7;(.q, . ,;(.\\i.uiv-ilmf{:-\u2019.-:-\\a e, -m\ufb02)&w\u2018u sibliian }L}LJ Lyei: \n~ \nDocunientation completed by .....: .\\.,,~ \nseasfeniaes b\u2018\\f\u2018tjb'\ufb02l ...... Date ...-\u2018..-..\u2018.\u2018-;.\/.gr;?f 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