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Dental Exam Record
Dental Patient Treatment Form
 
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List Price: $75.00
Your Price: $52.00
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Unit Qty: 250
Unit: pack
Overall Dimensions: 8-1/2" X 11"


Product Code: 21019
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Dental Exam Record with Anatomic Diagrams, Horizontal Format.  Record every detail of adult and primary dentition in a horizontal format ideal for file envelopes.

Size: 8-1/2" X 11"

Accurate charting and notes! Front features tooth charts with 1-32 numbering and a-t lettering, with a summary area for patient history. Back includes space for listing services and fees. Printed on sturdy ledger stock.

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