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Med. History Yellow 4/02Ear, Nose & Throat SpecialtyCare of Minnesota, P.A. Medical History Form PATIENT NAME: Please print ENT No Problems Ear Pain Hearing Loss Dizziness Nasal Congestion Sore Throat Hoarseness Lump in Neck No Problems Weight Loss Night Sweats Fever Fatigue Lungs No Problems Shortness Breath Chronic Cough Asthma/Wheezing … Retrieve Doc Symptoms Of [...]