Medical history
Family history
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Family history, specifics
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Social history
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Occupation of mother
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Occupation of father
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Personal medical history
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Allergy
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Medication
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Nicotine
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Alcohol
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Specifics
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Medical exam
General findings
Blood type
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Rh factor
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Antibodies
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Rubella titer
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HbsAG
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Height
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Weight
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Edemata
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Varices
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Urine test strip
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HIV
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Hepatitis C
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Current pregnancy, anamnesis of menstrual cycle
Last period
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Estimated due date (EDD)
date
Date of conception based on ultrasound diagnostics
date
Week of gestation
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Current pregnancy, complications
Complications and diseases, current pregnancy
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In-patient treatment
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In-patient treatment, reason
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In-patient treatment, duration
date
In-patient treatment, therapy
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