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W-PSGN-GN Patient Sign In Form
W-PSGN-GN Patient Sign In Form
 


Product Code: W-PSGN-GN
To order, call 1-800-722-4884

Description
 
Meet the needs of patient privacy expectations. Patients fill in information line on removable strip. Carbon sheet transfers names to back sheet so other patients do not see the previous patient's information. Acutal color is Light Green (form shown is light blue).
Overall size 8-1/2" W x 11" H.
250 forms per package.

Formerly Part Number 18229

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