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๐ท Patient Sticker (Optional - Auto-fill with OCR)
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Upload patient ID sticker to auto-fill form fields below
Surgeon *
Hospital *
Patient Last Name
Patient First Name
Procedure Date
Rep First Name
Rep Last Name
Surgery Type
Number of Levels
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1 LVL
2 LVL
3 LVL
4 LVL
5 LVL
Level Range (auto-calculated from # of levels)
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Notes
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Search Product *
Search by product description (e.g., "pedicle screw", "PEEK cage")
Catalog # (Part Number)
Lot #
Unit Price *
Quantity *
Total
In & Out (divides unit price by 2)
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Description *
Catalog # (Part Number)
Lot #
Unit Price *
Quantity *
Total
In & Out (divides unit price by 2)
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Image *
๐ Scan & Auto-Fill Form
Manual Entry (show all fields)
Part Number
Description
Catalog Number
Lot Number
Serial Number (SN)
Expiration Date
Manufacturer
Price *
In & Out (divides price by 2)
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Edit Case Information
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Surgeon *
Hospital *
Patient Name
Procedure Date
Rep First Name
Rep Last Name
Surgery Type
Number of Levels
Select...
1 LVL
2 LVL
3 LVL
4 LVL
5 LVL
Level Range (auto-calculated from # of levels)
-
Notes
Upload Patient Sticker
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Patient ID Sticker Image *
Photo of hospital patient ID label
Upload & Scan
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Patient Sticker
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Sticker
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