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