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I ordered dispensers of various types, got it shipped really fast... a happy customer.

James

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Milcom Child Registration and History Record

In stock
SKU
MPSBRG-2276R
More Information
Brand Sage
MPN 2276R
Packaging 1 per each
Size 17In x 11In overall ( 8 1/2In x 11In folded)
$163.31
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This record is completed by the parent or guardian on the initial visit and provides the physician with information on family history, development and behavioral issues, health and safety issues, hospitalization and serious illnesses, allergies and immunizations.

Designed and endorsed by STFM.
Updated to remain current.
Standardized and Versatile for consistency and easy integration into existing systems.
Developed to aid in RISK MANAGEMENT.
17" x 11" overall ( 8 1/2" x 11" folded), 4-page booklet-style form, white heavy paper, black and blue ink, printed two sides different, 5-hole punched top and side, wrapped in 100s.
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