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