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