History and Intake Form
Heart Valve Replacement. Heart Transplant . Knee replacement (R, L, bilateral) Hip replacement (R, L, bilateral) Joint replacement in past 2 years. Kidney removed (R, L) Kidney Transplant. Ovaries removed (cyst, ovarian cancer) Prostate removed: prostate cancer. Spleen removed. Testicles removed (R,L, bilateral) Hysterectomy (fibroids, uterine ... ................
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