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EFTA00110337
CL_ Pain Scale: /10. Dental Prostheses at Intake: Yes No Type: Ae: Condition: Comzrt _to z it t bettv r i i ..g),:iiilitca R Ce SS / OO DICX Sen.)-e- a Lot-Act 0--4,4 pc Ce-O-1,O-ini ojoScAle4 Intra-oral Photos Taken: . Yes 0 Radiographs Taken: (Document findings on A&O encounter) yes O • I
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