Drug	Why did you consume this drug?
Paracetamol / Acetaminophen	1 () 2 () 3 () 4 () 5 () 6 () 7 ()
Ibuprofen	1 () 2 () 3 () 4 () 5 () 6 () 7 ()
Azithromycin	1 () 2 () 3 () 4 () 5 () 6 () 7 ()
Hydroxychloroquine	1 () 2 () 3 () 4 () 5 () 6 () 7 ()
Penicillin	1 () 2 () 3 () 4 () 5 () 6 () 7 ()
Antiretroviral	1 () 2 () 3 () 4 () 5 () 6 () 7 ()
Another drug: ______________	1 () 2 () 3 () 4 () 5 () 6 () 7 ()