Symptom / Chief Complaint

Chest pain? Y NPrior Heart Attack? Y NLeg pain with walking? Y N. Palpitations? Y NFluid in feet? Y N. Gastrointestinal Tract. Heartburn? Y NUlcers? Y NHiatal Hernia? Y N. Chronic nausea? Y NCramping? Y NPoor Appetite? Y N. Chronic diarrhea? Y NBlood in stools? Y NPain in abdomen? Y N. Change in stools? Y N. Skins and Nails. Chronic rash? ................
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