Medical Survey

Have you ever had . . .

1. chicken pox? yes, 4th grade
   
2. pink eye? yes, last year
   
3. strep throat? yes, several times
   
4. mono? yes, 6th grade
   
5. mumps? no
   
6. measles? no
   
7. hives? yes, a few times
   
8. gallbladder attack? yes, terrible!
   
9. kidney stone? yes, worst pain ever!
   
10. broken bone? no
    
11. sinus infection? yes, a couple of times a year
12. ear ache? yes, but not often
    
13. toothache? no
    
14. backache? yes, rarely
    
15. leg cramp? yes, very often
    
16. surgery? yes, several--and one scheduled for summer
    
17. stitches? only from surgery
    
18. black eye? no
    
19. life-threatening illness? yes, several years ago
    
20. allergic reaction to medication? yes