National Next Of Kin Registry (NOKR) International Emergency Information Link                       

Society Complete Your Free Printable NOKR Registration Card
(Please do not add any information you would not like printed on your card)
First Name: Int. Last Name: Date Of Birth: (mm/dd/yyyy)
   
Street Address City / Town or District
     
State / Province Zip Code
     
Phone 1 Phone 2 Blood Type/Other Info.
     
 
Physician and or Dental Information
Physician
First Name Last Name Phone Number
Dentist  (Optional)
First Name Last Name Phone Number

 
Emergency Contact Registered with NOKR.org
If you have multiple contacts add theses contacts with NOKR		  
First Name    
Last Name    
Phone Number    
Date Registered with NOKR (mm/dd/yyyy)    
 
Enter Medical Conditions, Diseases and History
[Diabetes, Coronary Artery Disease, Congestive Heart Failure, etc...]
Look Up Current Vital Medical Information

Click here for spellings for some of the common medical conditions / medications?
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Taking Current Medications
Enter Drug Name; Dosage; Frequency
Look Up Current Vital Medical Information

Click here for spellings for some of the common medical conditions / medications?
1 Drug Name > Dosage > Frequency
2 Drug Name > Dosage > Frequency
3 Drug Name > Dosage > Frequency
4 Drug Name > Dosage > Frequency
5 Drug Name > Dosage > Frequency
6 Drug Name > Dosage > Frequency
7 Drug Name > Dosage > Frequency
8 Drug Name > Dosage > Frequency
9 Drug Name > Dosage > Frequency
10 Drug Name > Dosage > Frequency
 
Known Allergies / Other Information
Enter medications, food or other items to which you are allergic.
Look Up Current Vital Medical Information

Click here for spellings for some of the common medical conditions / medications?
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This information is not retained nor used for any purpose other than generating and
printing your NOKR emergency information card.

Information on the NOKR card is generated based on the information you the user has supplied above.