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Dental History ( ( ( ( ( ( ( ) ) ) ) ) ) ) Nutritional Disorders Prolonged Bleeding Rheumatic Fever Speech/Hearing Disorders Tonsillitis Tuberculosis ADD/ADHD Phone# Family Dentist:

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Page 1: Dental History ( ( ( ( ( ( ( ) ) ) ) ) ) ) Nutritional Disorders Prolonged Bleeding Rheumatic Fever Speech/Hearing Disorders Tonsillitis Tuberculosis ADD/ADHD Phone# Family Dentist:
Page 2: Dental History ( ( ( ( ( ( ( ) ) ) ) ) ) ) Nutritional Disorders Prolonged Bleeding Rheumatic Fever Speech/Hearing Disorders Tonsillitis Tuberculosis ADD/ADHD Phone# Family Dentist:
Page 3: Dental History ( ( ( ( ( ( ( ) ) ) ) ) ) ) Nutritional Disorders Prolonged Bleeding Rheumatic Fever Speech/Hearing Disorders Tonsillitis Tuberculosis ADD/ADHD Phone# Family Dentist:
Page 4: Dental History ( ( ( ( ( ( ( ) ) ) ) ) ) ) Nutritional Disorders Prolonged Bleeding Rheumatic Fever Speech/Hearing Disorders Tonsillitis Tuberculosis ADD/ADHD Phone# Family Dentist:
Page 5: Dental History ( ( ( ( ( ( ( ) ) ) ) ) ) ) Nutritional Disorders Prolonged Bleeding Rheumatic Fever Speech/Hearing Disorders Tonsillitis Tuberculosis ADD/ADHD Phone# Family Dentist:
Page 6: Dental History ( ( ( ( ( ( ( ) ) ) ) ) ) ) Nutritional Disorders Prolonged Bleeding Rheumatic Fever Speech/Hearing Disorders Tonsillitis Tuberculosis ADD/ADHD Phone# Family Dentist:

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