Pacific Dental Center

Quick Contact
Tel: 01715075740
Email: info@pacificdentalcenter.com

Patient Name	Registration No	Date

Guardian Name	Guardian Occupation	Age

Present Address	Permanent Address	Photo
Dinajpur	Do
Phone	Mobile	Email

Medical History
Hypertension	Diabetes	Pregnancy
MI	Bleeding Disorder	Kidney d.
Valular/Other HD.	Liver D.	Allergy
Hypersensitivity	Others
Chief Complains
<p><img alt="" src="/userfiles/s20190304_181435_0000.bmp" style="height:153px; width:111px" /> <img alt="" src="/userfiles/s20190304_190148_0000.bmp" style="height:153px; width:111px" /> <img alt="" src="/userfiles/s20190312_190727_0000.bmp" style="height:153px; width:111px" /> <img alt="" src="/userfiles/s20190312_190756_0000.bmp" style="height:153px; width:111px" />12.03.2019</p> <hr /> <hr /> <table border="1" cellpadding="1" cellspacing="1" style="height:30px; width:80px"> <tbody> <tr> <td>26/02/2019</td> </tr> </tbody> </table> <p>06,07,2019 <img alt="" src="/userfiles/s20190706_183327_0000.bmp" style="height:153px; width:111px" /></p>
Investigations
<p><img alt="" src="/userfiles/20190304_191202.jpg" style="height:144px; width:117px" /> <img alt="" src="/userfiles/20190312_192122.jpg" style="height:142px; width:108px" /></p>
On Examination

Diagnosis

Treatment Plan
<p>RCT LR6</p>
Estimate
<p>5000</p>
I am agree to get treatment by getting information about my problem and treatment

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