5. Month of birthFill one circle[] January - March[] April - June[] July - September[] October - December
6. Year of birthFill one circle for first three numbers[] 186_[] 187_[] 188_[] 189_[] 190_[] 191_[] 192_[] 193_[] 194_[] 195_[] 196_[] 197_Fill one circle for last number[] 0[] 1[] 2[] 3[] 4[] 5[] 6[] 7[] 8[] 9