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Patient Info

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Last Name
Cua
First Name
Mariz
Middle Name
Inocencio
Birthdate
January 3, 1990
Age
28
Street
ALC
Barangay
Garnet Road
City
MANDALUYONG
Country
Philippines
Zip Code
1234
Contact number
9088693202
Procedure
01-29-2021 > ICF = 500 > EXO W/BME REMOVAL #48 = 3,500 > X RAY =1,000 12/09/22- payment for ivo 02/11/23 TF #16 03/08/23 Exo #26 ozone suture Gel foam xray Tooth Freeze, LC # 24 (Caoh,25,34) 12/12/25 OP - mild PA xray #38 LC #38 OM #11 M #21 M
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Retain Record
Yes