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Patient Info

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Last Name
Laig
First Name
Jose Antonio
Middle Name
A
Birthdate
March 1, 2004
Age
15
Street
3206 Tindalo St.
Barangay
UPS2
City
Paranaque city
Country
Zip Code
Contact number
09062884959
Procedure
11-08-2019 > OP +STAIN REMOVAL = 1,000 > SEALANT #16, 26, 36, 46 = 4,200
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Retain Record
Yes