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Lung Cancer

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Full Name *

Age *

Gender *

Do you have shortness of breath?

Do you have side pain?

Do you have a new pain in any place of the body?

Do you have a new headache?

Is there any blood in cough or sputum?

Do you have the history of previous tuberculosis?

Do you have the history of copd?

Do you use inhaler?

Do you take any anticoagulant?

Have you had any cardiac surgery?

Do you take any medication of thyroid?

Does anyone in your family have lung cancer?

Do you have weight loss? If so, how much weight have you lost?

Have you received chemotherapy-radiotherapy-immunotherapy?

If so, what is the termination date?

Has any PET-CT been performed?

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