[PERSON'S FIRST MIDDLE AND LAST NAME] [NAME OF MEDICAL CARE PROVIDER......] [ADM-DT] [DIS-DT]
Did (PERSON) receive an epidural or a 'spinal' for pain?

YES .................................... 1 [HS08]
NO ..................................... 2 [HS08]
REF ................................... -7 [HS08]
DK .................................... -8 [HS08]
HELP AVAILABLE FOR DEFINITION OF EPIDURAL/SPINAL.

[PERSON'S FIRST MIDDLE AND LAST NAME] [NAME OF MEDICAL CARE PROVIDER......] [ADM-DT] [DIS-DT]
Did (PERSON) receive an epidural or a 'spinal' for pain?

YES .................................... 1 [HS08]
NO ..................................... 2 [HS08]
REF ................................... -7 [HS08]
DK .................................... -8 [HS08]
HELP AVAILABLE FOR DEFINITION OF EPIDURAL/SPINAL.

[PERSON'S FIRST MIDDLE AND LAST NAME] [NAME OF MEDICAL CARE PROVIDER......] [ADM-DT] [DIS-DT]
Did (PERSON) receive an epidural or a 'spinal' for pain?

YES .................................... 1 [HS08]
NO ..................................... 2 [HS08]
REF ................................... -7 [HS08]
DK .................................... -8 [HS08]
HELP AVAILABLE FOR DEFINITION OF EPIDURAL/SPINAL.

[PERSON'S FIRST MIDDLE AND LAST NAME] [NAME OF MEDICAL CARE PROVIDER......] [ADM-DT] [DIS-DT]
Did (PERSON) receive an epidural or a 'spinal' for pain?

YES .................................... 1 [HS08]
NO ..................................... 2 [HS08]
REF ................................... -7 [HS08]
DK .................................... -8 [HS08]
HELP AVAILABLE FOR DEFINITION OF EPIDURAL/SPINAL.

[PERSON'S FIRST MIDDLE AND LAST NAME] [NAME OF MEDICAL CARE PROVIDER......] [ADM-DT] [DIS-DT]
Did (PERSON) receive an epidural or a 'spinal' for pain?

YES .................................... 1 [HS08]
NO ..................................... 2 [HS08]
REF ................................... -7 [HS08]
DK .................................... -8 [HS08]
HELP AVAILABLE FOR DEFINITION OF EPIDURAL/SPINAL.