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Get and Sign Pediatric Medical History Form North Park Pediatrics 2017-2022
Yes Delivered by elective C-section emergent C-section forceps vacuum extraction normal vaginal delivery If not a normal vaginal delivery why Number of weeks gestation Birth weight APGAR scores 1 minute 5 minute Discharge weight Did the baby receive the Hepatitis B vaccine No If yes date given Name of hospital where infant was born PERSONAL MEDICAL HISTORY Please check if your child has had any of the following medical problems ADD/ADHD Allergies Anemia Asthma Bleeding disorder Bronchiolitis...Show details
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