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