Yikes! Having that many fields in a table is generally a sign that the table is not normalized which is what I theorized earlier.
I see 4 date fields, if 4 dates are assoicated that describes a one-to-many relationship.
I see you have a couple fields for medications one of which looks like a summary (memo field). If a patient has many medications that is a one-to-many relationship thus a separate but related table.
I also go back to my earlier comments about the various variables; they should be records in a table that are then related to the patient.
I would need to understand what kind of data each field holds in order to sort out the correct table structure...