VA Form 10-10EZ
13b. last entry date. 13c. last discharge date. 13d. discharge type. 13e. military service number. 14. check yes or no a. are you a former prisoner of war yes no h. do you have a military dental injury yes no b. do you have a va service-connected rating yes no i. do you have a spinal cord injury yes no b1. ................
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