1981 |
If only one time ask:
2. How long did it last? - If 1 month or longer, enter in Section J. If less than 1 month, do no record.
**Did this condition last for at least 3 months? If "Yes," enter in Section J.
If "No," do not record unless it is an obvious permanent condition which began less than 3 months ago.
4a. When was (Condition) first noticed?
(Was it during the past 12 months or before that time?)
(Was it during the past 3 months or before that time?)
b. How old was -- when this was first noticed?
0 [] Condition from 56, 57, or 58 (NC)
5. Did -- have this condition at any time during the past 12 months?
0 [] Condition from 56, 57, or 58 (NC)
6a. Does -- still have this condition?
b. Is this condition completely cured or is it under control?