<%%VALUE(last_name)%%> <%%VALUE(first_name)%%> <%%VALUE(gender)%%> <%%VALUE(sexual_orientation)%%> <%%VALUE(age)%%> <%%VALUE(state)%%> <%%VALUE(mobile)%%> <%%VALUE(tobacco_usage)%%> <%%VALUE(alcohol_intake)%%> <%%VALUE(history)%%> <%%VALUE(surgical_history)%%> <%%VALUE(obstetric_history)%%> <%%VALUE(genetic_diseases)%%>