At the Doctor's Office

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Across
  1. 4. Typically a man whose spouse has passed away.
  2. 6. Where do you live?
  3. 9. Male, Female, Other, Decline to State
  4. 11. Not Married!
  5. 14. What is your postal code?
  6. 15. The status of your marriage is also called
  7. 16. Where do you work?
Down
  1. 1. What number can we reach you at?
  2. 2. Have a Husband/Wife/Legally binding partnership.
  3. 3. Typically a female whose spouse has passed away.
  4. 5. Who should we call in an emergency?
  5. 7. The company that provides your insurance.
  6. 8. This card has your insurance information.
  7. 10. The day you were born.
  8. 12. The place you were born.
  9. 13. Had a Husband/Wife/Legally binding partnership that has now ended but we are both alive.