WisdomTeeth.ie

Oral Surgery Referral Letter

Mr.M. Sharif Nayyar, Oral Surgeon
BDS, FDSRCSEd, M Surg Dent RCSEd, FFDRCSI (Oral Surgery)

Patient Details:

Patient Name:

Address:

Date of Birth:

Phone Home:

Phone Work:

Phone Mobile:

Referral Priority:	Radiograph included:	Treatment recommended under:
Urgent	Yes	LA
Routine	No	Sedation
		GA

Oral Surgery Referral Letter - Printing form

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