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Self
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Asthama
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Spouse
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Diabeties
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Father
Medical history ?
Yes
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Diabeties
Blood Preasure
Heart Diseases
Any Surgery
Asthama
Thyroid
Others
Mother
Medical history ?
Yes
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Diabeties
Blood Preasure
Heart Diseases
Any Surgery
Asthama
Thyroid
Others
Grandfather
Medical history ?
Yes
No
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Diabeties
Blood Preasure
Heart Diseases
Any Surgery
Asthama
Thyroid
Others
Grandmother
Medical history ?
Yes
No
Select if yes
Diabeties
Blood Preasure
Heart Diseases
Any Surgery
Asthama
Thyroid
Others
Daughter
Medical history ?
Yes
No
Select if yes
Diabeties
Blood Preasure
Heart Diseases
Any Surgery
Asthama
Thyroid
Others
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