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MOUNTAIN HOME ENT & ALLERGY PATIENTS PERSONAL MEDICAL HISTORY PATIENT NAME: DOB: AGE: CHIEF COMPLAINT (Why are you here?) HEIGHT: WEIGHT: DRUG ALLERGIES: Primary care provider (PCP): LIST ALL PRESCRIPTIONS

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What is patients personal medical history?

Patients personal medical history includes information about the individual's past illnesses, surgeries, medications, allergies, and family medical history.

Who is required to file patients personal medical history?

Patients or their caregivers are required to provide and update their personal medical history.

How to fill out patients personal medical history?

Patients can fill out their personal medical history by providing accurate and detailed information about their medical background, including any previous conditions and treatments.

What is the purpose of patients personal medical history?

The purpose of patients personal medical history is to provide healthcare providers with essential information to deliver proper care and treatment, and to help in diagnosing health issues.

What information must be reported on patients personal medical history?

Patients must report their past and present medical conditions, surgeries, medications, allergies, and family medical history.

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