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    Contact Details

    Dentist Name (required)

    Dentist Email (required)

    Patient (required)

    Appointment Date

    Appointment Type

    Patient Age

    Patient Gender

    More Details

    Colour

    Neck Colour

    Body Colour

    Incisal Colour

    Transparency

    Occlusal Staining

    Even More Details

    In Case Of Implant

    Implant type:

    Implant size:

    Teeth Details

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    11


     

    Upper


    [checkbox uppera use_label_element ""Bleach tray" "Retention tray" "Bite lifting tray" "1mm 2mm 3mm"]

    21


    22


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    25


    26


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    28


    48


    47


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    44


    43


    42


    41


     

    Lower


    [checkbox lowera use_label_element ""Bleach tray" "Retention tray" "Bite lifting tray" "1mm 2mm 3mm"]

    31


    22


    23


    24


    25


    26


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    28


    Finer Details

    Impression:

    Bite:

    Model type:

    Laborimplant:

    Alloy type:

    Weight type:

    Message / Comments:

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    Phone Number:

     

     

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    Richmond Ceramics dental laboratory has been in operation for over 20 years. We have a team of dedicated experienced dental technicians.