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[null,null,null,null,null,null,null,null,null,null,null,"Trouble Hearing? Y/N"]
[null,null,null,"Case History\nHisotrio del Caso",null,null,null,null,null,"Required Fields in Blue\nCampos Obligatorios en Azul"]
[null,null,"Name (Last, First, Middle)   Nombre (Apellido, Nombre, Segundo nombre)",null,null,null,null,null,null,"Date (mm/dd/yyyy)\nFecha",null,null,{"$f":"'Case History'!D10","v":0},null,null,{"$f":"CONCATENATE(D3,F3,H3,L4,P5)","v":"1900-01-00"}]
[null,null,"Mailing Address                                              Dirección Postal"]
[null,null,null,null,null,null,null,null,null,"Birthdate (mm/dd/yyyy)\nFecha de nacimiento",null,null,null,null,null,{"$f":"TEXT(L3,\"YYYY-MM-DD\")","v":"1900-01-00"}]
[null,null,null,null,null,null,null,null,null,"            Gender   Género      (M F)"]
[null,null,null,null,null,null,null,null,null,"File Name",{"$f":"P3","v":"1900-01-00"}]
[null,null,"Do you have trouble hearing?\n¿Tiene problemas de audición?"]
[null,null,"Oído derecho   Right Ear            Y/N"]
[null,null,"Oído izquierdo   Left Ear            Y/N"]
[null,null,"Trouble hearing on the phone?\n¿Problemas para escuchar por el teléfono?"]
[null,null,"Oído derecho   Right Ear            Y/N"]
[null,null,"Oído izquierdo   Left Ear            Y/N"]
[null,null,"Trouble hearing when talking to one person?\n¿Problemas para escuchar al hablar con una persona?"]
[null,null,"     Y/N"]
[null,null,"Trouble hearing in groups?\n¿Problemas para escuchar en en grupos?"]
[null,null,"     Y/N"]
[]
[null,null,"Alguna vez…      Have you ever…"]
[null,null,"used a hearing aid?\n¿Ha usado audifonos/aparatos auditivos? "]
[null,null,"Oído derecho   Right Ear            Y/N"]
[null,null,"Oído izquierdo   Left Ear            Y/N"]
[null,null,"               been exposed to loud noise?        Y/N\n¿Ha estado expuesto a ruidos fuertes?"]
[null,null,"Describa                  Describe"]
[null,null,"had ringing in your ears?"]
[null,null,"Oído derecho   Right Ear            Y/N"]
[null,null,"Oído izquierdo   Left Ear            Y/N"]
[null,null,"Describa                  Describe"]
[null,null,"had ear infections?\n¿Ha sentido zumbido en sus oídos?"]
[null,null,"Oído derecho   Right Ear            Y/N"]
[null,null,"Oído izquierdo   Left Ear            Y/N"]
[null,null,"Describa                  Describe"]
[null,null,"had ear surgery?\n¿Ha tenido cirugía de oído?"]
[null,null,"Oído derecho   Right Ear            Y/N"]
[null,null,"Oído izquierdo   Left Ear            Y/N"]
[null,null,"Describa                  Describe"]
[null,null,"had balance or dizziness problems?   Y/N\n¿Ha tenido problemas de balance o mareo?"]
[null,null,"Describa                  Describe"]
[null,null,"had ear trauma?\n¿Ha tenido algún trauma en su oído?"]
[null,null,"Oído derecho   Right Ear            Y/N"]
[null,null,"Oído izquierdo   Left Ear            Y/N"]
[null,null,"Describa                  Describe"]
[]
[null,null,"Other Information            Otra información"]