Past Medical History
Cardiac (Angina, heart attack, heart failure, murmur, artificial valve, rheumatic fever)
Respiratory (asthma, emphysema, other)
Neurological problems (CVA, TIA’s, epilepsy)
Diabetes
HIV or Hepatitis B or C, Jaundice
Kidney disease
Bleeding disorders, Anaemia
Blood pressure high or low
Adverse drug reactions
Allergies
Any other medical condition
