Form 104-2 Ledger and Treatment Record
Ample space for services rendered in a vertical format
- Back is same as front except without patient information
- Has space for medical alert
- Size 8½" x 11"
- Printed 2 sides
- Grey ink on white or yellow index stock
- 100 Per Package*
- 104-2W is on white stock
- 104-2Y is on yellow stock
*If no color is specified, Yellow will be sent.
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Form 104-2 Ledger and Treatment Record
This product was added to our catalog on Friday 02 September, 2005.
