| Name: | |
| Last name: | |
| Address: | |
| Date of birth: |
| Gilbert | Slovenščina |
| Zvišan krvni tlak | Slovenščina |
| Močna aritmija | Slovenščina |
| Šum na srcu | Slovenščina |
| Increased blood pressure | English |
| Gilbert | English |
| Noise at heart | English |
| Severe arrhythmia | English |
| Gilbert | German |
| Schwere Arrhythmie | German |
| Erhöhter Blutdruck | German |
| Lärm im Herzen | German |
| Gilbert | Hrvatski |
| Povišeni krvni tlak | Hrvatski |
| Teška aritmija | Hrvatski |
| Buka u srcu | Hrvatski |
| Gilbert | Spain |
| Aumento de la presión arterial | Spain |
| Arritmia | Spain |
| Gilbert | Bulgarian |
| Povisheno kruvno nalyagane | Bulgarian |
| Aaritmiya | Bulgarian |
| Shum v surtseto | Bulgarian |
| Gilbert | Italy |
| Aumento della pressione sanguigna | Italy |
| Aritmia | Italy |
| Rumore nel cuore | Italy |
| Gilbert | France |
| Arythmie | France |
| Le bruit dans l'âme | France |
| Gilbert | Russia |
| Shum v serdtse | Russia |
| Aritmiya | Russia |
| Gilbert | Portugal |
| Arritmia | Portugal |
| Barulho no coraçao | Portugal |
| Lekadol | Slovenščina |
| Aspirin | Slovenščina |
| Aspirin | German |
| Aspirin | English |
| Aspirin | Hrvatski |
| Aspirin | Spain |
| Aspirin | Bulgarian |
| Aspirin | Italy |
| Aspirin | France |
| Aspirin | Russia |
| Aspirin | Portugal |
| Nobenih alergij | Slovenščina |
| Keine Allergien | German |
| No allergies | English |
| Nema alergija | Hrvatski |
| Sin alergias | Spain |
| Bez alergii | Bulgarian |
| Nessuna allergia | Italy |
| Pas d'allergies | France |
| Net allergii | Russia |
| Sem alergias | Portugal |
| Leta 2000 - imel srčni zastoj | Slovenščina |
| Leta 1999 - imel poškodbo vratnih vretenc zaradi poškodbe na smučanju | Slovenščina |
| In year 2000 I had a cardiac arrest | English |
| In year 1999 - suffered a cervical spine injury due to a ski injury | English |
| Pacient Is Sportly Active |
| Patient Was Treated From Injuries |
| Patient Has Been Operated |
| Patient Has Heart Problems, Heart Rhythm Disturbances |
| Patient Has High Blood Pressure |
| Patient Has Problems With The Ears, Dizziness Or Balance |
| Patient Is Wearing Glasses Or Contact Lenses |
