1. Today's Date______Dec.2nd_______________
2. First Name ______Guangcan_____________________________________________
3. Middle Name _________________________________________________
4. Last Name _________Cheng__________________________________________
5. Maiden Name (if applicable) _____________________________________
6. I was born on ___________07/16/1995_______________(date) in the town/city of
7. __________________LUANAN city ANHUI province_____________________________________________ (location including hospital if
8. known)
9. I was born at __10:00_______ am/pm on a _____________ (day of week) LINK
10. My Birth Weight: ____3.8kg___________ My Birth Length: _______I don't know_____________
11. My Current address: _________________________________________________________________
12. My Father Is: _________Cheng xinjun______________________________________________________________
13. My Mother Is: __________Zhao tianqin____________________________________________________________
14. Complications at Birth?: ______________________________________________________________
15. Had I been born the opposite sex, my parents were going to name me _______NO____________________
16. My nationality is _____Chinese_______________ and my ethnic background is ________________________
17. I was born number _______1_ of 2________ children
18. I have _____1___ brother(s) & _______no_ sister(s) ________ step-brothers _______ step-sisters
19. My natural hair color is ____black_________________ My eyes are __________black______________ in color
20. My adult height is ___163cm__________ and my weight has ranged between ___47kg________ and ______49kg___
21. 
    
22. I wear glasses for:
    a) READING b) EVERYDAY c) I'VE NEVER WORN GLASSES
23. I am
    a) RIGHT-HANDED b) LEFT-HANDED c) AMBIDEXTROUS
24. I was named after someone NO
25. I have an interesting story/circumstance to tell about my mother getting to the hospital on time:
    YES
26. Additional Notes and Comments:
    So this is me . I'm Bella.