Material Handling Solutions Llc 4001 S Shary Rd Ste 550 Mission, TX 78572 Phone: 956-465-4177 Fax: 206-984-3770

Tops® Ub04 Hospital Insurance Claim Form printable version

Product No. TOP59770R Global Product Type Form Type Insurance Claim Format Continuous Form Form Size (W x H) Form Size 8 1/2 x 11 Forms Per Page Sheet Size Form Quantity Layout One Form per Sheet Punching Dot Matrix Holes Printer Compatibility Dot Matrix Paper Stock 20-lb. Paper Color(s) White Print and Ruling Color(s) Red Form Special Features Pre-Consumer Recycled Content Percent 0 % Post-Consumer Recycled Content Percent 0 % Total Recycled Content Percent 0 % CT $139.23 Quantity