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Patient Info

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Last Name
Peralta
First Name
Liezl Ann
Middle Name
Birthdate
November 30, 1985
Age
38
Street
523 Melchor bldg
Barangay
Avista Place sto Nino
City
Paranaque
Country
Zip Code
Contact number
09190926457
Procedure
09/07/24 Ivocap denture full upper shade A3 semi gumless anterior teeth 25,000 dp 5,000 Bal 20,000 for EXO #28 for filling #13, 15 09/18/24 trial denture DP 5,000 Bal. 15,000 10/09/24 install denture 10/19/24 LC #13 F #15 M #18 O
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Retain Record
Yes