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Bilet de trimitere DigiRay

Bilet de trimitere DigiRay*

*Se completează exclusiv de către medic
Clinica
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Medic
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Nume Prenume pacient
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1. CBCT - Computer Tomograf cu Fascicul Conic

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Zona
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Zona
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Dinte/dinți
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Viewer CBCT

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Zona
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Tip implant
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2. Ortopantomografie (OPG)

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3. Scanare intraorală

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Arcada
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Zona
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4. Ortodonție

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5. Radiografii intraorale

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Clinica DigiRay în care se va face trimiterea

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Mențiuni
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Semnătura dvs.:
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Informare GDPR:
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Pentru efectuarea radiografiilor nu este nevoie de programare.
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