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state of Illinois. 2. At the above time and date the defendant was operating his motor vehicle south bound on. Lewis Avenue to the North and rear of the vehicle ...
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Heart problem/Shortness of breath? Yes No Tobacco use (type, frequency)? Yes No. Heart murmur/High blood pressure? Yes No Alcohol/Drug use? Yes No. Dizziness or chest pain with. exercise? Yes No Family history of sudden death. before age 50? (Cause?)