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    🩺 Patient Information

    • First Name: —
    • Last Name: —
    • Date of Birth: —
    • Sex: —
    • Address: —
    • Doctor: —
    • Doctor Website: —
    • Medical Conditions: —

    Notice: Our AI system will ask about your personal and medical history to support accurate diagnostics and personalized care. All information will be anonymized and securely stored under HIPAA regulations. Your data will not be used without your explicit consent.