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Initial History QuestionnaireChild\'s Name:Form Completed By:Birth Date:Relationship to Patient:Age:Date Completed:Birth HistoryFOtherDon\'t know birth historyBirth Weight:Pre-delivery Method: VaginalPretermWeeksCesareanPrenatal/Neonatal
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Start by gathering basic information about what pregnant women need to know, such as prenatal care, nutrition, exercise, and childbirth classes.
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It is a document containing important information that every pregnant woman should be aware of.
Pregnant women are required to file it.
The form can be filled out either electronically or manually, following the instructions provided.
The purpose is to educate pregnant women about important aspects of pregnancy and provide necessary information.
Information such as due date, medical history, prenatal care details, and emergency contacts must be reported.
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