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Sentence

この用よう紙しの既き往おう歴れきの欄らんに記き入にゅうしてください。

Span Details

this; last (couple of years, etc.); these; past; you (as in "you liar")

-> 此のpre-noun adjective

用よう紙し

form; blank form; sheet of paper; paper

possession, attribution, nominalizer, or nominal linker

既き往おう歴れき

medical history; case history; anamnesis

possession, attribution, nominalizer, or nominal linker

section; column; page; field; blank; handrail; railing; banister

noun, noun suffix

direction, time, indirect object, or target marker

記き入にゅう

entry; filling in; filling out

noun, suru verb

してください。