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Lifestyle alcohol drink(s) per week number of years smoking pack(s) per day number of years exercise type(s) of exercise days per week xiii. Download template download example pdf. Web a personal health journal (health diary) is a record of your health. Date of birth * gender * phone * email * address * address line 1.
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Family medical history mother father sibling grand. By kate eby | january 18, 2019. Web printable medical records template. Web having a record of medical history is important for everyone.
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