please list the names of medications you are currently taking en liste

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PLEASE LIST THE NAMES OF MEDICATIONS YOU ARE CURRENTLY TAKING
EN LISTE POR FAVOR LOS NOMBRES DE LAS MEDICINAS QUE USTED TOMA ACTUALMENTE
PRESCRIPTIONS
HERBAL REMEDIES
REMEDIOS DE HIERBAS
PRESCRIPCIONES
VITAMINS
VITAMINAS
OVER THE COUNTER
DRUGS
MEDICINAS SIN RECETAS
HAVE YOU BEEN PREMEDICATED (DUE TO ALLERGIES) SPECIFICALLY IF FOR A CT EXAM?
YES
NO
DO YOU HAVE ALLERGIES TO FOODS, MEDICATIONS?
PLEASE LIST:
YES
NO
YES
NO
LATEX ALLERGY?
ARE YOU DIABETIC? YES NO
_______________________________________________________________________________________________________________
¿ALERGIAS A ALIMENTOS, MEDICINAS?
ESCRIBALAS POR FAVOR:
¿TIENE DIABETIS?
SI
NO
SI
NO
¿ALERGICO AL LATEX?
SI NO
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