FORM 5
[ ] Check this box if no longer
subject to Section 16. Form 4
or Form 5 obligations may
continue. SEE Instruction 1(b).
[ ] Form 3 Holdings Reported
[X] Form 4 Transactions Reported
U.S. SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934,
Section 17(a) of the Public Utility Holding Company Act of 1935 or Section
30(f) of the Investment Company Act of 1940
1. Name and Address of Reporting Person*
Last:Wittman Street: c/o Dental/Medical Diagnostic Systems, Inc.
200 N. Westlake Boulevard, Suite 202
First: Ronald City: Westlake Village
Middle: E State: CA Zip: 91362
2. Issuer Name and Ticker or Trading Symbol
Dental/Medical Diagnostic Systems, Inc. (Nasdaq "DMDS")
3. IRS or Social Security Number of Reporting Person (Voluntary)
4. Statement for Month/Year
February 1998
5. If Amendment, Date of Original
(Month/Year)
6. Relationship of Reporting Person to Issuer (Check all applicable)
[X] Director
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[ ] 10% Owner
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[X] Officer (give title below)
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[ ] Other (specify below)
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Chief Financial Officer and Vice President
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7. Individual or Joint/Group Filing
(Check applicable line)
X Form Filed by one Reporting Person
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--- Form Filed by more than one Reporting Person
<TABLE>
<CAPTION>
TABLE I -- NON-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED
</CAPTION>
<C> <C> <C> <C> <C> <C> <C>
1. Title of Security 2. Trans- 3. Transaction 4. Securities Acquired (A) 5. Amount of 6. Ownership 7. Nature of
(Instr. 3) action Code or Disposed of (D) Securities Form; Indirect
Date (Instr. 8) (Instr. 3, 4 and 5) Beneficially Direct (D) Beneficial
(Month/ <C> <C> <C> Owned at End or Indirect Ownership
Day/ Amt. (A) or Price of Issuer's (I) (Instr. 4)
Year) (D) Fiscal Year (Instr. 4)
(Instr. 3
and 4)
Common Stock 11/23/97 P 1,000 A $9.38 D
Common Stock 1,000 D
</TABLE>
If the form is filed by more than one Reporting Person, see Instruction 4(b)(v).
Reminder: Report on a separate line for each class of securities beneficially
owned directly or indirectly.
(Print or Type Responses) (Over)
PAGE 1
<PAGE>
Form 5 (continued)
<TABLE>
<CAPTION>
TABLE II -- DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED
(E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES)
</CAPTION>
<C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C>
1.Title 2.Conver- 3.Trans- 4.Trans- 5.No. of 6.Date Exer- 7.Title and 8.Price 9.No. of 10.Owner- 11.Nature
of sion or action action Deriv- cisable Amt. of of Deriv- ship of In-
Deri- Exercise Date Code ative and Ex- Underly- Deri- ative Form direct
vative Price of (Month/ (Instr.8) Securi- piration ing Secur- vative Securi- of Deri- Benefi-
Security Deriva- Day/ ties Ac- Date (Month/ ities Security ties vative cial
(Instr.3) tive Year) quired Day/Year) (Instr.3 (Instr.5) Benefi- Security: Owner-
Security (A) or and 4) cially Direct(D) ship
Disposed Owned or Indi- (Instr.
of (D) at End rect(I) 4)
(Instr.3 of Year (Instr.4)
4, and 5) (Instr.4)
<C> <C> <C> <C> <C> <C>
(A) (D) Date Expira- Title Amt or
Exer- tion No. of
cis Date Shares
able
Stock Option $4.50 5/8/97 A 25,000 5/9/97 5/8/02 Common 25,000 $0 D
(right to buy) Stock
Stock Option $5.125 9/18/97 A 25,000 * 9/18/07 Common 25,000 $0 D
(right to buy) Stock
Stock Option 50,000 D
</TABLE>
Explanation of Responses:
* Options will vest and become exercisable 20% per year for five (5) years.
** Intentional misstatements or omissions of facts contstitute Federal
Criminal Violations.
See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a)
/s/ RONALD E. WITTMAN February 17, 1998
- --------------------------- ---------------
**Signature of Reporting Person Date
NOTE: File three copies of this Form, one of which must be manually
signed. If space provided is insufficient, see Instruction 6 for procedure.
PAGE 2
<PAGE>
