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Patient Info

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Last Name
Rabulan
First Name
Rachelle Anne
Middle Name
Sison
Birthdate
April 2, 1991
Age
28
Street
Barangay
Cabuyao
City
laguna
Country
Zip Code
Contact number
09088824305
Procedure
10/09/21- 18ss UL/ all lower to right slant elastic penguin(front) rabbit (sides) 43 to 16/ 33 to right upper loop/ 36 to upper left loop 2/19/22- rpi 24 class 2 elastic penguin with c. hook 23 lingualbutton- s elastic fox U 16x16 ss/ L same wire 4/13/22- same wires/ upper chain/ force 2 elastic 8/20/22-16X 16 SS Ul/ CHAIN UPPER/ CLASS 2 ELASTIC RABBIT 12/28/22- ADJ 05/20/23- Ortho/UL - same wire/Penguin #13- #33 07/1/23- 16x22 upper/ lower class 2 elastic fox *48 for removal 08/26/23- same Wire/ Chain Lower 10/21/23- 12/02/23- same wire, chain upper 12 w/ single power O on the anterior, Class 2- rabbit 01/14/24 ADJ same wire upper chain 03/16/24 reattached #32 same wire IPR= lower 44/45 /43 cross elastic 23 to 43 05/31/24 re attached #32,#35 Adj same wire chain upper class II elastic fox 08/01/24 same wire 10/19/24 elastic class fox 50z 12/21/24 for removal on Jan same wire chain U/L class II elastic 5oz rabbit 02/01/25 removal of brace LC #21 I,F 06/07/25 teeth whitening
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Retain Record
Yes