SKU: TOP59870R |

TOPS, Ub04 Hospital Insurance Claim Form, 8.5 X 11, 1/page, 2,500 Forms (TOP59870R)

$333.15
Current Stock: 29
SKU: TOP59870R
UPC:
25932598708
Availability:
Usually Ships in 1-2 Days
YOUR QUOTE
SKU QTY Description Pack Price Quote
Add more products

Details

Printed to Government Printing Office standards. OCR ink for scanning. American Medical Association (AMA) approved format. For Laser Printers. Form Size: 8.5 x 11; Forms Per Page: 1; Form Quantity: 2,500; Layout: One Form per Sheet.

Dimensions

WEIGHT LENGTH WIDTH HEIGHT
26. 12.00 9.25 10.25

Attention CA Residents: 

Prop 65 Warning

WARNING : This product can expose you to chemicals including lead, which are known to the State of California to cause cancer, birth defects, or other reproductive harm. For more information, go to www.p65warnings.ca.gov.

Details
Printed to Government Printing Office standards. OCR ink for scanning. American Medical Association (AMA) approved format. For Laser Printers. Form Size: 8.5 x 11; Forms Per Page: 1; Form Quantity: 2,500; Layout: One Form per Sheet.
DIMENSIONS

Dimensions

WEIGHT LENGTH WIDTH HEIGHT
26. 12.00 9.25 10.25
SAFETY DATA SHEET