Categories: Clinical Forms : Prescription Blanks : New Jersey Prescription Blanks – 2 Part, Personalized, 4" W x 5-1/2" H, 100 Sets/Pad, 5 Pads/Pkg
0553735_NJ

New Jersey Prescription Blanks – 2 Part, Personalized, 4" W x 5-1/2" H, 100 Sets/Pad, 5 Pads/Pkg

Eye Wear Prescription, Call 800.637.1140 for Prescription Blank Order Form.
Patterson Office Supplies
Patterson Item #: 70554014
Mfg Item #: VJO-PTC36-PAT3
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Specifications

# of Parts:
2 part
Dimensions:
4" W x 5-1/2" H
Ink Color:
Black
Logo:
N
Manufacturer Name:
PATTERSON OFFICE SUPPLIES
Material:
Two-Part Carbonless (second part yellow)
Package Quantity:
100 Sets/Pad; 5 Pads/Pkg
Product Color:
White/Yellow
Security Features:
  • State seal pantograph printed on front and back of each blank
  • Barcode
  • Serial number starting at 0001
  • 2 Part – Both parts printed
  • Formatted and printed per state requirements.
  • State law requires all prescription orders to be faxed or mailed. Call 1-800-637-1140 for an order form.
  • State law requires an adult signature upon delivery of all prescripiton blank orders. An additional charge may apply.

Legend

Promotion
Auto Free Good
My Catalog
My Catalog (Rep)
On Formulary
On Contract
Prescription
Hazmat-Chargeable
Hazmat-No Charge
MSDS / SDS
List 1
No Freeze
Prices in Green indicate discounted price.