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Governorate ?
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Enter City ?
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Place ?
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Choose age ?
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Gender ?
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Are you work in medical field ?
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Yes No
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Are you smooking ?
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Yes No
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had close contact with a confirmed case ?
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Yes No
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Have you had a fever (over 38°C) in the past 24 hours ?
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Yes No
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What was the highest temperature, approx ?
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History of the onset of symptoms ?
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have you had body aches ?
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Yes No
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have you had a persistent cough ?
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Yes No
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have you had a runny nose ?
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Yes No
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have you had diarrhea ?
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Yes No
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have you had a sore throat ?
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Yes No
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have you had a headache ?
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Yes No
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did you feel that you were more quickly out of breath than usual ?
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Yes No
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Have you been diagnosed with chronic lung disease by a doctor ?
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Yes No
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Have you been diagnosed with diabetes by a doctor ?
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Yes No
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Have you been diagnosed with heart disease by a doctor ?
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Yes No
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Are you pregnant ?
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Yes No
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