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Prospective Oral Board Case Submission

This form is intended to collect case information for the AOBR oral board certification examination. When providing images, please first browse to the image on your hard drive using the browse button. Next please list the file name in the second box.

For instance, if you find the file "C:\My Images\102676.jpg" please use 102676.jpg in the second box.

NOTE: All images must be uploaded in JPEG (.jpg) format.

Please note fields marked with an asterisk (*) are required.

* Contributor:  
* Section:  

* Case History (short):    
 
       
* Findings:    
 
       
* Diagnosis:    
 

* Modality:  
ANGIO   CT   MR   NM   PF   US
* Image:  
* File Name:  

Optional:

  Modality:  
ANGIO   CT   MR   NM   PF   US
  Image:  
  File Name:  

  Modality:  
ANGIO   CT   MR   NM   PF   US
  Image:  
  File Name:  

  Modality:  
ANGIO   CT   MR   NM   PF   US
  Image:  
  File Name:  

  Modality:  
ANGIO   CT   MR   NM   PF   US
  Image:  
  File Name):  

  Modality:  
ANGIO   CT   MR   NM   PF   US
  Image:  
  File Name:  

  Modality:  
ANGIO   CT   MR   NM   PF   US
  Image:  
  File Name:  

  Modality:  
ANGIO   CT   MR   NM   PF   US
  Image:  
  File Name:  

  Modality:  
ANGIO   CT   MR   NM   PF   US
  Image:  
  File Name:  

  Modality:  
ANGIO   CT   MR   NM   PF   US
  Image:  
  File Name:  

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