Follow-up form

Do you have low blood pressure? Does your skin have a bluish hue? Do you have an enlarged heart? Do you have difficulty breathing at night? Do you have a history of tubercolosis? Do you have asthma? Do you have hiccups? Do you have chronic cough? Do you cough a lot of phlegm? Do you spit/cough blood? Do you have gastric ulcers? Do you vomit blood? ................
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