Age:
Last Mammogram Date:	Select 1 month ago 2 months ago 3 months ago	Results:	Select Abnormal normal
Last colonoscopy Date:	Select 4 years ago 5 years ago 6 years ago	Results	Select Abnormal normal
Last osteoporosis screening Date:	Select Never done 6 years ago 16 years ago	Results	Select Abnormal normal N/A
Exercise regimen
Alcohol Frequency
Current Medication