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

James

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Patient Transfer 2-Part Carbonless Form 879/2

In stock
SKU
MPSBRG-879/2
More Information
Brand Sage
MPN 879/2
Packaging 1 per each
Size 8 1/2In x 11In
$124.00
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Developed by the Associated Hospital Service of New York, this form provides all the necessary patient information for the receiving facility when transferring a patient.

Also available:
2-part carbon interleaved
3-part carbon interleaved-extra copy Medicare intermediary (Stock No. 880/3)


Download a sample today!
  2 part carbonless; 8 1/2" x 11" 
  Detached-white original, color-coded copies; black ink 
  Wrapped in 100s
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