|
Did you ever have: |
yes/no |
when? |
Did you ever have: |
yes/no |
when? |
|
|
Blood Transfusion |
n |
High Blood Pressure |
n |
|||
|
Measles |
n |
Venereal Disease |
|
|||
|
Mumps |
n |
Kidney Disease |
n |
|||
|
Chickenpox |
y |
5 years old |
Epilepsy |
n |
||
|
Scarlet Fever |
n |
Anemia |
n |
|||
|
Rheumatic Fever |
n |
Major Surgeries |
none |
|||
|
Diabetes |
n |
Other |
Last Month Sore Throat |
|
||
|
Heart Disease |
n |
Other |