Scribd Logo
Upload

Welcome to Scribd!

  • 1 views

    SHD Form 1 - EMPLOYEES Page 6

    Uploaded by

    krishnagazelle.gansico
    Health Form Deped

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd

    SHD Form 1 - EMPLOYEES Page 6

    Uploaded by

    krishnagazelle.gansico
    1 views1 page
    Health Form Deped

    Original Title

    SHD-Form-1_EMPLOYEES-page-6

    Copyright

    © © All Rights Reserved

    Available Formats

    DOC, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Health Form Deped

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    1 views1 page

    SHD Form 1 - EMPLOYEES Page 6

    Uploaded by

    krishnagazelle.gansico
    Health Form Deped

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    of 1

    SHD Form 1-Da

    Name : ____________________________________________ LRN : __________________________________

    F.Y. F.Y.

    RIGHT 55 54 53 52 51 61 62 63 64 65 LEFT RIGHT 55 54 53 52 51 61 62 63 64 65 LEFT

    TEMPORARY TEETH TEMPORARY TEETH

    18 17 16 15 14 13 12 11 21 22 23 24 25 26 27 28 18 17 16 15 14 13 12 11 21 22 23 24 25 26 27 28

    PERMANENT TEETH
    PERMANENT TEETH

    48 47 46 45 44 43 42 41 31 32 33 34 35 36 37 38 48 47 46 45 44 43 42 41 31 32 33 34 35 36 37 38

    TEMPORARY TEETH TEMPORARY TEETH

    RIGHT 85 84 83 82 81 71 72 73 74 75 LEFT RIGHT 85 84 83 82 81 71 72 73 74 75 LEFT


    F.Y. ORAL HEALTH CONDITION

    RIGHT 55 54 53 52 51 61 62 63 64 65 LEFT Kinder 1 2 3 4 5 6

    7 8 9 10 11 12
    Gingivitis
    TEMPORARY TEETH
    Periodontal Disease
    18 17 16 15 14 13 12 11 21 22 23 24 25 26 27 28 Malocclussion
    Supernumerary teeth
    Retained decidous teeth
    PERMANENT TEETH

    48 47 46 45 44 43 42 41 31 32 33 34 35 36 37 38 Decubital ulcer
    Calculus
    Cleft lip / palate
    TEMPORARY TEETH
    Root fragment
    Fluorosis
    Others, Specify
    RIGHT 85 84 83 82 81 71 72 73 74 75 LEFT

    You might also like