Have you smoked in the last 12 months? 
General Health Questionairre

        

                                                                            

                                                                                              

                                                                                              

                                                                                              

                                                                                              

                                                                                              

                                                                                              

                                                                                             

                                                                                 

                                                                            
                                                                                    

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