This Entity is Patient History

I need to figure out the attributes that I should have from these two forms for PatientHistory entity and possible candidate keys

HEALTH HISTORY FORM 2 Do you have or have you ever had any of the following Symptoms/Illness NO YES, Explain Symptoms/ Illness NO YES, Explain Fever or Chills Breast Abnormalities Nipple Discharge Last Mammogram Changes in Moles Weight Loss Date: HIV/Other Blood Diseases Bleeding Disorders Endocrine Thyroid Problems History of Keloids Neurological Problems Headaches GENITOURINARY Genital or Oral Herpes S.T.D.'s Blood in Urine Urinary Tract Infection Problems Urinating Prostate Problems Kidney Problems Eyes Vision Problems Arthritis Mobility/Joint Problems GASTROINTESTINAL Constipation Blood in Stool Liver Problems CARDIOVASCULAR Heart Problems Deep Vein ThrombosDVT Blood Clots in Lungs/Legs High Blood Pressure RESPIRATORY Hearing Problems Sinus Problems PSYCHLATRIC Mood Swings Anxiety/Depression Sleep Apnea Please list any other conditions/illnesses not indicated above: best of my know6ecte, this form ation as complete and correct. I understand that my responsbdy to irform my doctor there aro amy danes to my he Patient Signature: Date: Physician Signature: Date Reviewed