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Health Survey
What is your gender?
Male
Female
What is your age?
What is your height?
What is your weight?
Have you ever smoked?
Yes
No
Do you regularly practice the following exercises?
Walking
Running
Swimming
Biking
Other
I don't exercise
If you walk for exercise, how long does it take you to walk one mile?
If you run for exercise, how long does it take you to run one mile?
If you bicycle for exercise, how many miles do you bike per day?
How many hours a week do you usually exercise?
How many hours a day do you usually sleep?
Verification No.