Categories: Clinical Forms : Prescription Blanks
70110189_170110262 Ca Rx Standard 0120 update_Dental

California Prescription Blanks – 1 User, 2 Part, Personalized, 8-1/2" W x 3-2/3" H, 100 Sheets/Pad, 10 Pads/Pkg

Patterson Office Supplies
Patterson Item #: 012-7688
Mfg Item #: VJO-PTC12-PAT3
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Specifications

# of Parts:
2 part
Design Color:
Blue
Dimensions:
8-1/2" W x 3-2/3" H
Ink Color:
Black
Logo:
N
Manufacturer Name:
PATTERSON OFFICE SUPPLIES
Material:
Two-Part carbonless stock; First Part – 26 lb white CB Security Paper with reflex blue, thermochromatic magenta and black ink on face and security ink on back. Second Part – 20 lb blank canary CF
Package Quantity:
100 Sets/Pad; 10 Pads/Pkg
Product Color:
White/Yellow
Security Features:
  • "void" pantograph
  • microprinted signature line
  • security back print
  • rug or breath on thumbprint to verify authenticity
  • sequential numbering starting at 0001 every order
  • CA requires an adult signature at time of delivery for all prescription blank orders. An additional fee may apply.
State Requirements:
Meets

Legend

Promotion
Auto Free Good
My Catalog
My Catalog (Rep)
On Formulary
On Contract
Prescription
Hazmat-Chargeable
Hazmat-No Charge
MSDS / SDS
Schedule 2 and 2N
Schedule 3, 3N, 4 and 5
List 1
No Freeze
Prices in Green indicate discounted price.