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Version (Print): 08.2023Medical History Full Name:___Current Symptoms & Condition: Do you suffer or have suffered from any of the following conditions, if yes since when? Thyroid?Yes [ ] / No [ ] If yes, since: ___Heart Disease?Yes [ ] / No [ ] If yes, since: ___Epilepsy?Yes [ ] / No [ ] If yes, since: ___Asthma?Yes [ ] / No [ ] If yes, since: ___Diabetes?Yes [ ] / No [ ] If yes, since: ___Cancer?Yes [ ] / No [ ] If yes, since: ___High
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Version Print 08 is a specific iteration of a document or form used for reporting or filing purposes, often associated with tax or regulatory submissions.
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