I hereby certify that the above information is complete and accurate.
我特此证明,上述资讯是正确的。
I hereby certify that Information on this form is accurate and complete.
本人谨此声明此表及后附之医生报告中提供的所有咨询完整、属实。
I hereby certify that: All the information on this form is true and correct.
我特此证明:本表所填写的内容和提供的材料真实无误。
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