問もん診しん票ひょう
Meanings
Noun
1. medical questionnaire; medical interview sheet; medical history form
Other spellings
問もん診しん表ひょう
Kanji used
Kanji in other spellings
Composed of
問もん診しん
interview (with a doctor); history taking
Noun
票ひょう
vote; ballot; label; ticket; tag; stub
Noun