CMS-1500 (02/12) Claim Forms, 2-Part Continuous, Nonpersonalized, 9-1/2" W x 11" H, 500/Pkg

Patterson Office Supplies
Patterson Item #: 196-2000
Mfg Item #: VJO-962000-PAT3
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Specifications

# of Parts:
2 part
Compatible Envelopes:
9" W x 4-1/2" H: 073-5324 Security-Lined, Gummed-Flap, 073-5381 Security-Lined, Self-Seal. 9-1/2" W x 4-1/8" H and 9" W x 13" H envelopes check website or call 800-637-1140.
Design Color:
Red
Dimensions:
9-1/2" W x 11" H, 8-1/2" W x 11" H (detached)
Manufacturer Name:
PATTERSON OFFICE SUPPLIES
Material:
Two-Part (White/White) Carbonless Stock
Package Quantity:
1,000/Pkg
Pin Feed Size Left:
1/2
Pin Feed Size Right:
1/2
Product Color:
White

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.