First line: Name of wearer
First eight spaces, Army serial number
; ninth space vacant; tenth, eleventh, and twelfth spaces, record of tetanus immunization (date completed), (letter T and the last two numerals of the year); thirteenth space vacant; fourteenth and fifteenth spaces, the last two numerals of the year in which the immunity stimulating injection of the tetanus toxoid is completed; sixteenth space vacant; seventeenth space, the letter signifying the blood type; eighteenth space vacant unless the blood type is indicated by two letter. For example: "33333333 T41 42 A"; or, "33333333 41 42 AB". Blood types are indicated by the symbols "A","B","AB", or "O"
Third line: Name of person to be notified in case of emergency.
Fourth line: Street address of person to be notified in case of emergency.
Fifth line: City and State address of person to be notified in case of emergency. The religion of the wearer, when stated, will be stamped in space 18 of the fifth line if that space is vacant, otherwise in space 18 of the fourth line, and will be indicated by a capital letter as follows: C for Catholic; H for Hebrew, and P for Protestant.