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Patient Info

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Last Name
Asto
First Name
Samantha Ysabel
Middle Name
Banico
Birthdate
July 2, 2010
Age
8
Street
Malugay
Barangay
San Martin De Porres
City
Taguig
Country
Philippines
Zip Code
Contact number
Procedure
09-01-2018 > CONSULTATION 06-22-2019 > FLOURIDE = 800 FOR SEALANT #16,26,36,46 12-04-2019 > OP =800 10/16/21 exo decidous teeth upper E/E LR
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Retain Record
Yes