YUNUEN Y

MARIAN DENTAL CLINIC

PERSON LISTON
*Name: Juanito Alcachofa Sex: Male Date of Birth: March 15, 1985
Blood Type: O+ Address: 123 Dental street, Tooth ville Age: 39
Phone Number: +1(555) 123 4567
Emergency contact: Shawn Mendez (spouse) +1 (555) 987-6543

MEDICAL HISTORY
* General Health: Overall good health, no major medical issues
* Medications: None
*Allergies: No known allergies
* Medical conditions: None

DENTAL HISTORY
* Last Dental Visit: January 10, 2024
+ Reason for VIsIt: Routine check-Up and cleaning
*Dental concerns: Mild sensitivity in lower left molars
* Oral Hygiene Habits: Brushes twice daily, Flosses regulary
*Tobacco/ Alcohol Use: No-smoker, ocasional social drinker
*Dental X-rays: Last taken on January 10, 2024

DENTAL TREATMENT HISTORY:

* Previdos dental procedures: Fillings in upper right premolars
* Orthodontic treatment: Had braces during adolescence
* Dentures/ implants: None
ADi gA Wieden teeth extraction at ageo
Juanito prefers a soft-bristle toothbrush, He avoids sugary snacks and acidic beverages, No recent dental trauma or accidents.

Calle Cualquiera 123, Cualquier Lugar

673-143-2293

rojomarian2209@gmail.com