• Father and mother: Age ,health, date and cause of death.

  • Siblings: List with ages, health

    • ( if dead, mention cause of death)
  • Family disease: CVA or other disease e.g. Huntington’s chorea, Heredofamilial ataxia. Familial periodic paralysis/ Peroneal mus. Atrophy, diabetes mellitus, hypertensive disorders, and migraine.