Filling Out Medical Forms

Filling Out Medical Forms Bingo Card
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This bingo card has a free space and 37 words: health insurance card, medications, allergies, emergency contact information, date of birth, symptoms, family medical history, age, immunizations, health screening tests, personal medical history, social history, tobacco use, address, surgical history, patient, patient registration form, mailing address, SS#, spouse, parent or guardian, relationship, Race, socioeconomics, income information, proof of identity, positive, negative, address, name, phone number, insurance company, policy number, proof of residency, expiration date, consent for treatment and male / female.

⚠ This card has duplicate items: address (2)

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