CMS 02/12 Insurance Claim Form, 2-Part, White/Canary, 9...
$169.99
Required by Centers for Medicaid and Medicare Services (CMS) and by most private healthcare organizations, these forms speed up claims processing...
Material Requisition Book, 7 7/8 x 4 1/4, Two-Part Carbonless, 50-Set Book
$5.49
Tax excluded
Space for quantity, description and price of materials to be purchased or transferred. Wrap-around stop card prevents write-through to other form sets. Punched for storage in post binder.
RED1L114
1930 Items
Data sheet
- Punching
- Side, Two-Hole
- Punching
- Hanging Hole
- Paper Color(s)
- Blue
- Paper Color(s)
- White
- Global Product Type
- Forms-Requisition & Record Requests
- Pre-Consumer Recycled Content Percent
- 0%
- Post-Consumer Recycled Content Percent
- 0%
- Total Recycled Content Percent
- 0%
- Form Size
- 7 7/8 x 4 1/4
- Forms Per Page
- 1
- Number of Entry Lines
- 9
- Form Quantity
- 50
- Principal Heading(s)
- Material Requisition
- Layout
- One Form on Page
- Print and Ruling Color(s)
- Blue
- Numbering
- Preprinted Listing Lines
- Numbering
- Preprinted at Top
- Numbering Color(s)
- Red
- Numbering Color(s)
- Blue
- Copy Types
- Carbonless Duplicate
- Copy Paper Color(s)
- Yellow
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Nine numbered ordering lines. Space for quantity, description and price of materials to be purchased or transferred. Consecutively numbered in red. Two-hole punched to fit post binders. Black-print carbonless duplicates. Wrap-around stop card prevents write-through.