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Chris Smith Today's Date: mm/dd/yyyy  Current Illnesses Use the check boxes below to select items   Name Medication Diagnosed Heart Condition Aspirin 01/01/1998 Skin Condition Minocyclin 05/08/2000 Headake Analgin 20/08/2000  Past Illnesses Use the check boxes below to select items   Name Medication Diagnosed Ablamabla Tetracycline 12/34/1945  Procedures Use the check boxes below to select items   Name Date Injection 11/08/2000

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