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