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Last Name: Miguel

First Name: John Russel

Middle Name: Sampayan

Birthdate: August 2, 2002

Age: 24

Street: Purok 3

Barangay: Palacian

City: Aglipay

Country: Philippines

Zip Code: 3403

Contact number: 09366710492

Email: russelmiguel95@gmail.com

Procedure: 05/06/26 OP Xray LC #16-O,L 05/13/26 EXO #36 | #26 16- clinda | 6-trane note: flexite 12,000 upper 16,000 lower 05/23/26 EXO #46 Chromic suture 06/03/26 check up 06/27/26 - Doc Thea impression U/L for flexite denture shade A2 07/04/26 wax trial of upper and lower (flexite denture) 07/11/26 flexite denture of upper and lower delivered -follow up checkup on July 25, 2026 07/25/26 recall for flexite denture -follow up checkup on Aug 7, 2026 08/07/26 check up

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Retain Record: Yes