Briggs Form CFS5-1/3 conveniently contains all pertinent information regarding the resident upon admission. It may also be utilized to document a brief discharge summary.
In the event the resident expires, a Morticians Receipt is located on back side of the original.
8 1/2" x 11" (detached), 3-part carbonless snap set, white original, color-coded copies, black ink, Part 1 prints front and back, Parts 2 and 3 print front only, 5-hole punched top or side, wrapped in 100s.
