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| Do you have seasonal allergies? | |
| Do you ever cough up blood? | |
| Do you have a morning cough? | |
| Do you produce sputum with the cough? | |
| If so, what color? | |
| How many pillows do you sleep on? | |
| Have you had a flu vaccine? | |
| Have you had a pneumonia vaccine? | |
| When was your last chest x-ray? |