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![Page 1: · 7. Do you use cocaine or other drugs? Cl 8. Are you allergic or had an adverse reaction to any drugs or medications? [2 9. Are you in good health at this time? C] 10. Are you](https://reader033.cupdf.com/reader033/viewer/2022042312/5eda787ab3745412b57165a7/html5/thumbnails/1.jpg)
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