Pediatric - Personal Medical History

Please correct the errors described below.

To the parent: In order to ensure a complete and accurate understanding of your child's medical history, please take the time to answer the following questions. Please, be as complete as possible.

BIRTH HISTORY

Pregnancy

Neonatal period

Did the patient:

SOCIAL HISTORY

Has your child ever been diagnosed with or had to take medication for any of the following conditions?

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