Mucosal Examination Charts - Universal_01-08-07
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14 38 34 15 48 33 24 25 26 28 23 37 27 Form A - Upper/Lower Arch Mucosal Examination Chart 47 17 Patient name: Case Number: Exam Date: Clinician: Clinical LIP LIP © 2007 LED Dental Inc. 01-08-07 ® 46 34 36 38 35 48 45 37 Form B: Tongue-Lateral View Form C: Tongue Underside 47 Clinical LIP © 2007 LED Dental Inc. 01-08-07 ®
Transcript of Mucosal Examination Charts - Universal_01-08-07
LEFTRIGHT
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www.velscope.com
Clinical
Impression:_________________________________________________________________________
Mucosal Examination ChartPatient name:Case Number:Exam Date:Clinician:
Form A - Upper/Lower Arch
LIP
LIP
© 2007 LED Dental Inc. 01-08-07
LEFTRIGHT
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Mucosal Examination ChartPatient name:Case Number:Exam Date:Clinician:
Form B: Tongue-Lateral View
Form C: Tongue Underside
48 47 46 45 44RIGHT LEFT
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www.velscope.com
Clinical
Impression:_________________________________________________________________________
LIP
© 2007 LED Dental Inc. 01-08-07
