MEDICAL HISTORY - Breast Augmentation | Breast Implants

yes no yes no Rashes or itching Breast pain Palpable lumps or nodules Nipple inversion Skin cancer Nipple discharge Fibrocystic breast disease Present bra size: Date/Result of last mammogram: Neurologic yes no yes no Migraine headaches Numbness or tingling sensations Dizziness Weakness Blackouts ................
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