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Please fill this form So that our doctor can help you better
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what is Your chief complaint?
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After what change you are facing this complaint &How did it start?
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Since How many days/months/years are you facing this problem
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When the complaint is more
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Morning
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After which activity the complaint is more?
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Drinking
Bathing
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Urination
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Any other complaint (in any other part of the body with chief complaint)
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Address
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Phone number
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