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Patient Questionnaire
For: Charles Rodriguez
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Symptoms
Please indicate which symptoms you are experiencing
Pain in or around the ear
Fluid coming from the ear
Difficulty hearing or muffled sounds
Feeling unsteady or lightheaded
Elevated body temperature
Pain in the head or face
Stuffy or runny nose
Pain or irritation in the throat
Persistent or occasional coughing
Feeling unusually tired or exhausted
Itching in or around the ears
Skin rash or irritation