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Patrick's forehead first appears when Patrick Star eats some of Sandy's unknown toxic waste and a miniature version of himself grows on his forehead. When SpongeBob says that he is going to find a new job, Forehead Patrick says that he will never get a job, so Patrick punches him.
In the episode "Patty Hype," SpongeBob asks Patrick why he is angry. Patrick replies that because he cannot see his forehead.