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Quality Control (QC) Form
YDL Evaluation (
on cast
) Crown & Bridge Lab Critque Form
*
indicates required field.
*
Product Service Type:
*
Doctor Name:
Margins:
-- Select --
Good
Open
Short
Extended
Anatomy:
-- Select --
Acceptable
Good
Poor
Not Acceptable
Occlusal Contact:
-- Select --
Good
Heavy
Light
None
Prox. Contact:
-- Select --
Good
Open
Irregular
Contour:
-- Select --
Good
Under
Over
FIT:
-- Select --
Good
Loose
Rocking
Shade:
-- Select --
Good
Off
Prescription:
Yes
No
Returned Die:
condition
-- Select --
Intact
Broken
Modified
*
Comments:
YDL Evaluation (
mouth
) Crown & Bridge Lab Critque Form
*
indicates required field.
*
Date:
*
Work Order:
Margins:
-- Select --
Good
Open
Short
Extended
Anatomy:
-- Select --
Acceptable
Good
Poor
Not Acceptable
Occlusal Contact:
-- Select --
Good
Heavy
Light
None
Prox. Contact:
-- Select --
Good
Open
Irregular
Contour:
-- Select --
Good
Under
Over
FIT:
-- Select --
Good
Loose
Rocking
Shade:
-- Select --
Good
Off
Prescription:
Yes
No
Returned Die:
condition
-- Select --
Intact
Broken
Modified
*
Comments:
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