Filling Out Medical Forms - Call List

(Print) Use this randomly generated list as your call list when playing the game. There is no need to say the BINGO column name. Place some kind of mark (like an X, a checkmark, a dot, tally mark, etc) on each cell as you announce it, to keep track. You can also cut out each item, place them in a bag and pull words from the bag.

1. spouse
2. expiration date
3. SS#
4. policy number
5. proof of residency
6. age
7. emergency contact information
8. name
9. address
10. address
11. health insurance card
12. phone number
13. immunizations
14. social history
15. income information
16. relationship
17. date of birth
18. proof of identity
19. parent or guardian
20. socioeconomics
21. insurance company
22. patient
23. positive
24. surgical history
25. allergies
26. male / female
27. mailing address
28. patient registration form
29. personal medical history
30. tobacco use
31. symptoms
32. family medical history
33. medications
34. negative
35. health screening tests
36. consent for treatment
37. Race