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! Birthday (D-M-Y):
! colspan="3" | <div class="dob-d">{{{field|birth day|size=2|input type=combobox|values={{BioboxListOfDates}}|placeholder=DD|size=2|existing values only}}}</div>
! colspan="3" | <div class="dob-m">{{{field|birth month|size=10|input type=combobox|values={{BioboxListOfMonths}}|placeholder=Month|existing values only}}}</div>
! colspan="3" | <div class="dob-y">{{{field|birth year|input type=combobox|values={{BioboxListOfYears}}|placeholder=YYYY|size=4|existing values only}}}</div>
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! Place of Birth: