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