Lab Case Entry Lab Case Entry Slip Number * Dr Name * Patient Name * Shade * A1A2A3A3.5A4B1B2B3B4C1C2C3C4D1D2D3D4 Lower / UpperNoneLowerUpper Reciving Date * Required Date * Tooth Chart Upper Right Upper Left Lower Right Lower Left Section Case Type * PFM DigitalPFM SimpleZirconiumZirconium PremiumRetainerNightgaurdTemperoryTemperory DigitalNc MetalPFM + Zirconium * New CaseRepeat CaseNew +Repeat * SimpleUrgent Bite Recived * NoneYes recived Trays Recived * NoneL-HalfU-HalfU/L-HalfL-FullU-FullU/L-Full Save Case If you are human, leave this field blank.
