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