Patient Info

First Name Lordson

Last Name L

Age 24

Address 22 st. George road

Mobile 8610846702

Phone

e mail

Treatment

Medical History

Dental History

Details

Date of visit

Total [Payments]: 2,500

295 Date of visit05/03/2022 C/C & Rx plans TreatmentsDiastema closure with composite Prescription Payment2,500.00 Balance Follow up date Lab

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Appointment Details

Time

Appointment Date