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