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Past Medical History - None
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Past Medical History
• • •
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Past Medical History Freewrite
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Past Surgical History - None
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Surgical History
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Past Family History - None
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Family Medical History
• • •
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Family Medical History Freewrite
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Patient Smoking Status
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Comments (year quit, packs per day etc)
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Alcohol
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Other substances
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Occupation
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Marital Status
• • •
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Comments
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