div class=trans-pagebutton class=gotoPage data-page=1Page 1button div class=trans-imageimg data-url=documentben-thompson-dmd-cold-soresfever-o-yes-o-no-yes-no-heart-pacemaker-heart-troublediseasehtmlpage=1 data-page=1 class=trans-thumb lazyload alt=Page 1: Ben Thompson DMDCold SoresFever O Yes O No Yes NO Heart Pacemaker Heart TroubleDisease O Yes No If yes Have you had any serious illness not listed above Yes No Corrments To loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAEAAAABCAQAAAC1HAwCAAAAC0lEQVR42mM8Uw8AAh0BTZud3BwAAAAASUVORK5CYII= data-src=https:reader034fdocumentsnetreader034viewer20220504145f8b176df5d84321df1a201bhtml5thumbnails1jpg width=140 height=200 divdiv