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Last Name
Dela Pena
First Name
Evita Wilma Cassandra
Middle Name
V
Birthdate
July 13, 1991
Age
33
Street
138 Los Angeles St.
Barangay
Tramo 2 San Dionisio
City
Paranaque
Country
philippines
Zip Code
Contact number
09297868162
Procedure
02/08/25 cast analysis 12 series of PA 02/14/25 instl of brace 14 U&L NiTi 03/21/25 reattached #16/26 rw #12 same wire 04/29/25 adj 16 NiTi lower reattach #26 05/31/25 niti 18 u niti 16 l o coil spring 11-12 21-22 ligature wire 41/31 07/01/25 adj 16 SS U/L 11/07/25 adjustment same wire reattach #36 replace lost brackets #16 elastic rabbit 3.5oz 12/17/25 reverse curve 18 NiTi upper 18 ss lower 2 rotational wedge elastic chipmunk 3.5oz elastic penguin 3.5oz 01/16/26 adjustment elastic: chipmunk 3.5 penguin 3.5 01/22/26 Re-attached Buccal tube #16
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Retain Record
Yes