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MEDICAL HISTORY QUESTIONNAIRE MEDICAL HISTORY QUESTIONNAIRE Today's Date: / / Today's Date: / / Name: Nickname: Date of Birth: / / Name: Nickname: Date of Birth: / / Primary Care Physician: Primary
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January 20, 2023
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You can simply write down today's date in the format MM/DD/YYYY
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The purpose of todays date is to keep track of current date and time
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