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