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Patient Info

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Last Name
Rivera
First Name
Jan Emmanuel
Middle Name
Laquidanum
Birthdate
March 14, 2004
Age
15
Street
2458 Samapaloc St.
Barangay
United Hills
City
Parañaque City
Country
PHILIPPINES
Zip Code
Contact number
823-3243
Procedure
09/18/21- removal of braces/ cleaning and polishing done, impression for clear retainers 09/24/21- lower retainer delivered upper repeat impression 10/16/21 redo retainer upper and lower/ impression done 06/22/24 OP 12/27/25 OP
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Retain Record
Yes