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