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Last Name: Bongaros

First Name: Nadjarah

Middle Name: mangorsi

Birthdate: February 5, 1986

Age: 36

Street: 2673 Duhat St. UHV phase 1

Barangay

City: Parañaque City

Country

Zip Code

Contact number: +63 921 339 3400

Email

Procedure: 3/22/22- OP Lc 13 m/ 21 d/ 22 m/ 47 o/ b/ cervical xray 14 for rct 10/11/22 - OP (L); ACCESS #14, SCOUT #10 BL 18mm, EUGENOL. 10/14/22- 12/11/21/22- TF emax veneers 10/19/22 - 19mm, close w/ pulp devitalizer 09/02/23- op ** For change of crowns posterior Lower for Crown #15 08/13/24 OP

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Retain Record: Yes