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{{ReferralNotification}}
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Endodontics
Referral
Examination
Emergency Treatment
Treatment Plan
Root Treatment
Recall / Review
Summary
Referral
Examination
Emergency
Treatment Plan
Root Treatment
Recall / Review
Summary
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User Manual
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Clinical Summary
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Consent Letter Adult
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Consent Letter Minor
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Room
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Referral
Referral
Referral
Referral
No.
DATE
PROVIDER
TOOTH NUMBER
REMARKS
ACTION
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REFERRAL FORM
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Internal
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Tooth Number
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Reason of Referral
Brief History
Diagnosis/Findings
Referral Detail
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From
{{Referral.FromDr}}
Date
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Reason for Referral
{{Referral.ReasonReferral + 'Z' | date :'dd MMMM yyyy'}}
To
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Patient
{{Referral.Name}}
ID Number
{{Referral.ID_Number}}
Tooth Number
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Brief History
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Diagnosis/Findings
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