This book still has notes and sticky notes from when I took the Public Health Nurse National Examination. I used it a lot, with a book cover on it. The outside is very clean!! I'm selling it in the hopes that it will be helpful for your national exam. *Please understand that this is a personal inspection, so I will sell it to those who can accept this. *Please note that the colors in the images may appear different depending on your smartphone or PC model and settings. *I cannot be held responsible for any claims, returns, refunds, or problems during shipping. *There are no smokers or pets.