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Rheumatic fever / Yes and no / Health / Bisphosphonate / Alendronic acid / Medicine


Nathan Lukes, DDS and Associates Health Questionnaire Name _________________________________ Sex _____ D.O. B. ___________________ Spouse or parent (if applicable) _______________________________ Employer _______________
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Document Date: 2014-09-23 01:58:23

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Company

Primary Insurance Company / DDS and Associates / Secondary Insurance Company / /

IndustryTerm

dental insurance / /

MedicalCondition

allergies / disease Diabetes Hepatitis/Liver Problems Stroke Heart Attack/Chest Pain Tuberculosis High/Low / injury / HIV / diseases / AIDS / illness / Rheumatic Fever Arthritis/Rheumatism Stomach Ulcers Sinus trouble Asthma/Hay fever Seizures/Fainting / /

MedicalTreatment

surgery / /

Person

Nathan Lukes / /

Position

physician / /

Product

Didronel / Actonel / Fosamax / Boniva / Zometa / Aredia / /

Technology

x-ray / /

SocialTag