Ideal for practices that prefer not to record fees on their treatment notes. Form includes basic patient information. Two-sided with back of form ruled. Printed flip-up style. Package of 250. Size 8-1/2×11″.
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Ideal for practices that prefer not to record fees on their treatment notes
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Form includes basic patient information
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Two-sided with back of form ruled
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Printed flip-up style
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Package of 250
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Size: 8-1/2″ x 11″
| # Up Per Sheet/Page : 1 | Binding Type : Loose | Brand : Medical Arts Press | Carbonless : No |
| Customizable : No | Form Size : 8-1/2″ x 11″ | Form Type : Clinical | Format : Dental Exam Chart |
| Holes Punched : None | Media Quantity : 250 | NCR Paper : No | Number of Parts : 1 |
| Numbered : No | Personalization : No | Security Features : No | Sheet Size : 8-1/2″ x 11″ |
| Weight : 2.96 lbs. per Pack |





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