3 Head & Neck / Soft Tissue: O: C 7 lv P L I ClassL5cation: CL_rr Pain Scale: /10. Dental Prostheses at Intake: Yes No Type: fi e" Calditicn: Comml .k rim r-toz SS / 14.., 0 -0-- O---‘, cet On 017Sal• Le^ ni )r_15,1Ai • or C/o-OAJA1 plosefik-4 InUa-oral Photos Taken: Yes 0 R