Paginating and Bates numbering medical records means giving every page in the set one unique, permanent number, in a fixed order, after the records are sorted and duplicates are removed. Use a short prefix, a fixed digit count and one stamp position, number every page including blanks and fax covers, and never reuse a number.
What a Bates number on a medical record looks like
A Bates number on a medical record is a short prefix followed by a fixed-length sequence number, stamped in the same spot on every page. A typical one reads "EXLEH-000143": a prefix that names the production or the source, a separator, and six digits with leading zeros. The number identifies that one page for the rest of the case.
Each part has a reason:
- Prefix. A few capital letters that tell a reader where the page came from. Many teams use one prefix per provider or per production, so "EXLEH" might stand for a fictional Lakeview Example Hospital. Some cases use one prefix for the whole set instead. Pick one approach and keep it.
- Separator. A hyphen keeps the prefix and number apart when read aloud or typed into a search box.
- Digit count. Six digits allow up to 999,999 pages per prefix and keep numbers the same length, so they sort correctly as text. Fewer digits can run out on a large hospital production.
- Stamp position. Many teams use the lower right corner, in the margin. Wherever it goes, it must not cover record text, dates or signatures. Check a few dense pages before stamping the whole set.
Here is a sample prefix scheme for three productions from different providers in a fictional case. Every name and number is an example.
| Production | Provider (fictional) | Prefix | First number | Last number | Pages |
|---|---|---|---|---|---|
| 1 | Lakeview Example Hospital | EXLEH | EXLEH-000001 | EXLEH-000212 | 212 |
| 2 | Riverbend Example Family Practice | EXRFP | EXRFP-000001 | EXRFP-000087 | 87 |
| 3 | Northside Example Physical Therapy | EXNPT | EXNPT-000001 | EXNPT-000140 | 140 |
Keep this table with the case file. It is the key that tells anyone what a prefix means and where each range ends. Those ranges then feed the index; the guide to the columns a litigation records index needs shows how.
Pagination before Bates numbering: which comes first?
Pagination comes first. Put the pages in their final order, remove duplicates, and confirm nothing is missing before stamping a single Bates number. Bates numbers are meant to be permanent, so every change to the page order after stamping forces either renumbering or awkward fixes such as suffixed numbers.
The order of operations for a medical record set:
- Sort the records by provider, then by date within each provider.
- Deduplicate the working copies, keeping the originals as received.
- Check for gaps before numbering, so a missing month can be requested and slotted in.
- Fix the page order inside each document, including rotated and out-of-order pages.
- Stamp Bates numbers on every page, in that final order.
- Verify that the last number on each prefix equals its page count.
Renumbering later causes trouble because the numbers spread fast. They go into the index, the chronology, emails and notes. If page EXLEH-000143 becomes EXLEH-000139 after a duplicate is removed, every reference to the old number now points at the wrong page.
Removing duplicates is the step most often done too late. The guide on whether deduplication is safe after Bates numbering explains the trade-off. The general method for deduplicating pages in medical records belongs before this step for that reason.
Gap checks belong before numbering too, but they do not always catch everything. The method in finding gaps in a set of medical records helps you request missing records early, while the set is still open.
Bates numbering supplemental records that arrive late
Supplemental records that arrive after the set is numbered get new numbers that continue the existing range or start a new prefix. They never reuse a number already stamped, and they never get slotted in by renumbering the original pages. The original numbers stay exactly as they were.
There are two common ways to handle a supplement:
- Continue the range. A second production from the fictional Lakeview Example Hospital starts at EXLEH-000213, one after the last stamped page. This keeps one prefix per provider. The pages sit after the original set, out of date order, and that is fine; the index and chronology put them in context.
- Start a new prefix. Some teams give each production its own prefix, such as EXLEH2-000001. This makes it obvious which pages came later. The prefix table needs a new row explaining it.
Either way, record the supplement in the prefix table with its date received, first number and last number. A supplement that turns out to duplicate pages already numbered should still be numbered if it is part of what was received. Note the overlap in the index rather than leaving pages unstamped.
Avoid inserting pages with suffixes such as EXLEH-000143.1 unless the case already uses that convention. Suffixes break sorting and are easy to miss.
Should blank pages and fax cover sheets get a Bates number?
Yes. Every page in the production gets a Bates number, including blank pages, fax cover sheets, separator sheets and pages that look like they belong to someone else. Numbering every page is what lets anyone show that the set is complete and that nothing was removed between receiving the records and reviewing them.
Blank pages are often the back of a one-sided page scanned in duplex mode. They look like noise, but skipping them means the page count no longer matches what the provider sent. If a provider later says it sent 212 pages, your numbers should account for all 212.
Fax cover sheets carry useful facts: the sending facility, the date sent, the page count claimed and sometimes the name of the person who sent them. A cover sheet that says "14 pages" when the packet holds 12 is the first clue that pages went missing in transit. Number it and keep it in front of the pages it came with. The medical faxes and referrals category covers how faxed records arrive and what their headers show.
How a production is organized can also be set by court rules, which say nothing about blank pages but do speak to order and labelling. In federal civil cases, Federal Rule of Civil Procedure 34 on the LII site gives a responding party two default choices: hand over records in the arrangement they had in normal business, or arrange and label them to match what the request asked for. Which choice fits a given production is for the case's attorney to decide.
Once the pages are numbered, the content of typed records can be read by software. Schema Care reads encounter dates, problem lists, allergies and vitals from medical records, each with a confidence score and a link to its place on the page; it does not stamp Bates numbers. The full list of document types Schema Care reads is on the homepage.