0 Dental Prostheses at Intako: Yes No Type: Age: Condlion: Cowl ek RCe SS / LoLjta - C,..-s...ko..4 = et in 1 vca De) CIPSen.)-e- • or Cal-Oa:MS 0.105refil 4 Intra-oral Photos Taken: Yes 0 Radiographs Taken: (Document findings on MO encounter) Yes No • Instructed how to obtain urgen