ck /Soft Tissue: - D: 1O Classitimtion: C L -I- 24: 1 F: 1 Li Pain Scale: /10 Dental Prostheses at Intake: Yes No Type: Age: Conaion: Comrioni 4c, o IC 02 SS / Z.O--)e-s- C.--,. a. cin 01;i iSel an /r3 / Vr a StrUlt or Ca. -L.31/Ac O.1a SCAM-4 Intra-oral Photos Taken: Yes Radiogra