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Health Maintenance
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Mammogram
|
Mammogram status
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Mammogram: Month
• • •
|
Day
• • •
|
|
Year
• • •
|
Comments
|
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Pap Smear
|
Pap Smear status
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Pap Smear: Month
• • •
|
Day
• • •
|
|
Year
• • •
|
Comments
|
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Colon Screening
|
colon screening status
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Method of screening
• • •
|
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Date of colon screening: Month
• • •
|
Day
• • •
|
|
Year
• • •
|
Comments
|
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Low Dose Lung CT
|
Low dose Lung CT status
|
|
Date last low dose lung CT
• • •
|
|
|
Low dose lung CT : Month
• • •
|
Day
• • •
|
|
Year
|
Comments
|
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Bone Density Scan
|
Bone density status
|
|
Bone Density: Month
• • •
|
Day
• • •
|
|
Year
|
Comments:
|
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Flu Shot
|
Flu shot status
|
|
Flu Shot: Month
• • •
|
Day
• • •
|
|
Year
• • •
|
|
|
Pnuemonia Shot
|
Pneumonia Shot status
|
|
Pneumonia shot
• • •
|
|
|
Pneumovax Shot: Month
• • •
|
Day
• • •
|
|
Year
• • •
|
|
|
Prevnar 13 Shot: Month
• • •
|
Day
• • •
|
|
Year
• • •
|
|
|
Eye Exam
|
Eye exam status
|
|
Eye Exam: Month
• • •
|
Day
• • •
|
|
Year
• • •
|
Comments
|
