div class=ts-pagebuttonPage 1button div class=ts-image a href=https:reader042vdocumentsusreader042viewer20220410165ec7da1fb14bb1689d2362cdhtml5page1jpg target=_blank amp-img class=ts-thumb alt=Page 1: · MEDICAL HISTORY If female please answer the following: Bennardi Barberio 42 S Main st Muncy PA 17756 Physician Phone: Pharmacy Phone: Please explain your answers N Gum disease src=https:reader042vdocumentsusreader042viewer20220410165ec7da1fb14bb1689d2362cdhtml5thumbnails1jpg width=142 height=106 layout=responsive amp-imga divdivdiv class=ts-pagebuttonPage 2button div class=ts-image a href=https:reader042vdocumentsusreader042viewer20220410165ec7da1fb14bb1689d2362cdhtml5page2jpg target=_blank amp-img class=ts-thumb alt=Page 2: · MEDICAL HISTORY If female please answer the following: Bennardi Barberio 42 S Main st Muncy PA 17756 Physician Phone: Pharmacy Phone: Please explain your answers N Gum disease 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Phone: Pharmacy Phone: Please explain your answers N Gum disease src=https:reader042vdocumentsusreader042viewer20220410165ec7da1fb14bb1689d2362cdhtml5thumbnails4jpg width=142 height=106 layout=responsive amp-imga divdivdiv class=ts-pagebuttonPage 5button div class=ts-image a href=https:reader042vdocumentsusreader042viewer20220410165ec7da1fb14bb1689d2362cdhtml5page5jpg target=_blank amp-img class=ts-thumb alt=Page 5: · MEDICAL HISTORY If female please answer the following: Bennardi Barberio 42 S Main st Muncy PA 17756 Physician Phone: Pharmacy Phone: Please explain your answers N Gum disease src=https:reader042vdocumentsusreader042viewer20220410165ec7da1fb14bb1689d2362cdhtml5thumbnails5jpg width=142 height=106 layout=responsive amp-imga divdivdiv class=ts-pagebuttonPage 6button div class=ts-image a href=https:reader042vdocumentsusreader042viewer20220410165ec7da1fb14bb1689d2362cdhtml5page6jpg target=_blank amp-img class=ts-thumb alt=Page 6: · MEDICAL HISTORY If female please answer the following: Bennardi Barberio 42 S Main st Muncy PA 17756 Physician Phone: Pharmacy Phone: Please explain your answers N Gum disease src=https:reader042vdocumentsusreader042viewer20220410165ec7da1fb14bb1689d2362cdhtml5thumbnails6jpg width=142 height=106 layout=responsive amp-imga divdivdiv class=ts-pagebuttonPage 7button div class=ts-image a href=https:reader042vdocumentsusreader042viewer20220410165ec7da1fb14bb1689d2362cdhtml5page7jpg target=_blank amp-img class=ts-thumb alt=Page 7: · MEDICAL HISTORY If female please answer the following: Bennardi Barberio 42 S Main st Muncy PA 17756 Physician Phone: Pharmacy Phone: Please explain your answers N Gum disease src=https:reader042vdocumentsusreader042viewer20220410165ec7da1fb14bb1689d2362cdhtml5thumbnails7jpg width=142 height=106 layout=responsive amp-imga divdivdiv class=ts-pagebuttonPage 8button div class=ts-image a href=https:reader042vdocumentsusreader042viewer20220410165ec7da1fb14bb1689d2362cdhtml5page8jpg target=_blank amp-img class=ts-thumb alt=Page 8: · MEDICAL HISTORY If female please answer the following: Bennardi Barberio 42 S Main st Muncy PA 17756 Physician Phone: Pharmacy Phone: Please explain your answers N Gum disease src=https:reader042vdocumentsusreader042viewer20220410165ec7da1fb14bb1689d2362cdhtml5thumbnails8jpg width=142 height=106 layout=responsive amp-imga divdivdiv class=ts-pagebuttonPage 9button div class=ts-image a href=https:reader042vdocumentsusreader042viewer20220410165ec7da1fb14bb1689d2362cdhtml5page9jpg target=_blank amp-img class=ts-thumb alt=Page 9: · MEDICAL HISTORY If female please answer the following: Bennardi Barberio 42 S Main st Muncy PA 17756 Physician Phone: Pharmacy Phone: Please explain your answers N Gum disease src=https:reader042vdocumentsusreader042viewer20220410165ec7da1fb14bb1689d2362cdhtml5thumbnails9jpg width=142 height=106 layout=responsive amp-imga divdivdiv class=ts-pagebuttonPage 10button div class=ts-image a href=https:reader042vdocumentsusreader042viewer20220410165ec7da1fb14bb1689d2362cdhtml5page10jpg target=_blank amp-img class=ts-thumb alt=Page 10: · MEDICAL HISTORY If female please answer the following: Bennardi Barberio 42 S Main st Muncy PA 17756 Physician Phone: Pharmacy Phone: Please explain your answers N Gum disease src=https:reader042vdocumentsusreader042viewer20220410165ec7da1fb14bb1689d2362cdhtml5thumbnails10jpg width=142 height=106 layout=responsive amp-imga divdivdiv class=ts-pagebuttonPage 11button div class=ts-image a href=https:reader042vdocumentsusreader042viewer20220410165ec7da1fb14bb1689d2362cdhtml5page11jpg target=_blank amp-img class=ts-thumb alt=Page 11: · MEDICAL HISTORY If female please answer the following: Bennardi Barberio 42 S Main st Muncy PA 17756 Physician Phone: Pharmacy Phone: Please explain your answers N Gum disease src=https:reader042vdocumentsusreader042viewer20220410165ec7da1fb14bb1689d2362cdhtml5thumbnails11jpg width=142 height=106 layout=responsive 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