Page 23 of replacement superbill forms
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Better Office 2-Part Carbonless Sales Order Book, 4.13" x 7.19", 50 Sets/Book, 6 Books/Pack (66006-6PK)
Item #: 901-24557977
Sales order book is a convenient way to stay organized and track all customer transactions in your business
Size: 4.13" x 7.19"
Each carbonless two-part set features a white top sheet for recording each transaction and a bottom canary yellow sheet that captures written text from the top sheet
$33.99
Per pack
Custom Work Orders, Job, Carbon, Small Format 2 Parts, 1 Color Printing, 5 1/2" x 8 1/2", 500/Pack
Item #: 901-D2582
Custom printed business forms, with time-saving features & expert personalization
Extra-large work description area, including 13 lines for detailed write-ups
Signature line for customer authorization prevents disputes
Medical Arts Press® Tamper-Resistant Secure Rx Blanks; Single Sheet
Item #: 901-15970
Verification Box - Hold marked area between thumb and forefinger, or breathe on heat-sensitive box, the color will disappear, then reappear
Coin Reactant Ink - Rub the Rx mark on left with a coin. Ink will turn from white to gray
MicroPrint - The right and left side rules of the large box on the front have the word "security" in microPrint. Can be viewed with magnifying glass
Adams 2-Part Carbonless Purchase Requisitions, 8.44"L x 5.56"W, 50 Sets/Book, 10/Box (DC5831-10)
Item #: 901-DC583110
Keep a bound copy for a permanent record using this purchase requisitions
Business form size: 8.44"L x 5.56"W; detached form size: 7.94"L x 5.56"W
2-Part Carbonless forms for accurate record keeping
$93.99
1-3 pack
Save 3%
$90.99
4+ pack
Medical Arts Press® Single Copy Rx Blanks; Vertical, Alter-Proof
Item #: 901-16034
Tamper-resistant Rx pad features 5 security features; meets October 1st 2008 Medicaid Requirements
Alter-proof blue pattern background to ensure there are no erasures or modifications of information
Void Pantograph — the word "void" will appear when photocopied
Medical Arts Press® Tamper-Resistant Secure Rx/2-Part Carbonless
Item #: 901-13377
Verification Box - Hold marked area between thumb and forefinger, or breathe on heat-sensitive box, the color will disappear, then reappear
Coin Reactant Ink - Rub the Rx mark on left with a coin. Ink will turn from white to gray
MicroPrint - The right and left side rules of the large box on the front have the word "security" in microPrint. Can be viewed with magnifying glass
Custom Release to School / Work Slips, 4" x 5-1/2", 100 Sheets per Pad
Item #: 901-QFN131071R
Return to work or school forms
4" W x 5-1/2" L
White 20# text stock; printed in black ink
Rediform 2-Part Carbonless Driver's Daily Logs, 9.13"L x 5.5"W, 31 Sets/Book (REDS5031NCL)
Item #: 901-REDS5031NC
Driver's daily log book is providing plenty of space to record driving time
Size: 9.13"L x 5.5"W
Features 2-part format that allows you to keep a permanent copy for your records
$11.09
1-10 each
Save 4%
$10.59
11+ each
ComplyRight 1-Part Personnel Folder, 25/Pack (A223)
Item #: 901-1949180
Personnel folder keeps quick information on the outside and confidential records on the inside
One-part personnel folder
Contains 25 folders per package
$87.99
Per each
Adams 3-Part Carbonless Sales Orders, 7.19"L x 4.19"W, 50 Sets/Book (TC4705)
Item #: 901-196105
Sales and order books are ideal for keeping proper records of orders and sales
Business form size: 7.19"L x 4.19"W
Features a carbonless 3-part format that allows you to keep a permanent copy for your records
$9.99
1-7 each
Save 5%
$9.49
8+ each
TOPS 2-Part Carbonless Purchase Requisitions, 10.69"L x 8.38"W, 50 Sets/Book (46146)
Item #: 901-388373
Purchase order books are designed to help you write order memos in a clear manner
Business form size: 10.69"L x 8.38"W; detached form size: 10.19"L x 8.38"W
Features a carbonless 2-part format that allows you to keep a permanent copy for your records
$40.99
1-5 box
Save 4%
$38.99
6+ box
Custom Dental Appointment Excuse Slips, 4" x 5-1/2", 100 Sheets per Pad
Item #: 901-QFN131421R
Excuse forms for dental appointments
4" W x 5-1/2" L
White 20# text stock; printed in black ink
Adams 2-Part Carbonless Purchase Order, 8 3/8" x 11 7/16", 50 Sets/Book (DC8131)
Item #: 901-301655
2-part carbonless purchase order formbook in white, canary paper sequence
Consecutively numbered within each book
Space at top for company stamp
$19.49
Per each
ComplyRight™ Employee Records Folder, Letter Size, Pack of 25 (A5001)
Item #: 901-1949184
Made in the U.S.A of thick, long-lasting manila card stock
Developed by Employment Attorneys for 100% Compliance
Easily fits into any filing cabinet or desk drawer
$87.99
Per each
Custom All-Purpose Excuse Slips, 4" x 5-1/2", 100 Sheets per Pad
Item #: 901-QFN131521R
Excuse forms for work or school
4" W x 5-1/2" L
White 20# text stock; printed in black ink
Custom Illness/Injury Excuse Slips, 4" x 5-1/2", 100 Sheets per Pad
Item #: 901-QFN131511R
Excuse forms for injuries and illnesses
4" W x 5-1/2" L
White 20# text stock; printed in black ink
Adams 2-Part Carbonless Receipts, 2.75"L x 7.13"W, 200 Sets/Book (DC1182)
Item #: 901-DC1182
Money and rent receipt book is consecutively numbered for easy organization
Size: 2.75"L x 7.13"W; page size 11"L x 7.63"W
2-Part Carbonless forms for accurate record keeping
$22.59
Per each
Adams 2-Part Carbonless Sales Orders, 4.19"W x 7.19"L, 50 Sets/Book, 3 (DC4705-3)
Item #: 901-448240
Sales order books are ideal for keeping proper records of orders and sales
Form size: 4.19"W x 7.19"L
2-Part Carbonless forms for accurate record keeping
$28.99
1-3 pack
Save 3%
$27.99
4+ pack
Rediform 2-Part Carbonless Purchase Requisitions, 4.25"L x 7.88"W, 50 Sets/Book (1L114)
Item #: 901-421005
Material requisition book is consecutively numbered for easy organization
Business form size: 4.25"L x 7.88"W
Features a carbonless 2-part format that allows you to keep a permanent copy for your records
$18.09
Per each
Rediform 2-Part Carbonless Money Receipt Book, 2.75" x 7", 200/Pack (8L806)
Item #: 901-8L806
Money-receipt book is consecutively numbered for easy organization
Business-form size: 2.75"L x 7"W
Features a carbonless 2-part format that allows you to keep a permanent copy for your records
$24.99
1-3 each
Save 4%
$23.99
4+ each
Adams Record Book, 8 Columns, 11" x 8.5", White, 50 Sheets/Book (S1185)
Item #: 901-628054
The record book is a great product for busy offices, walk-in advising centers, call centers, and other high-traffic businesses to keep track of activities and follow-ups
White paper pages
Includes 100 letter-size pages
$9.99
Per each
TOPS Receipts, 2.75"L x 7.13"W, 100/Pack (46808)
Item #: 901-46808
Money receipt book is consecutively numbered for easy organization
Envelopes are not included
Business form size: 2.75"L x 7.13"W; sheet size: 10.88"L x 7.63"W
$21.99
1-2 each
Save 1%
$21.59
3+ each
Custom Purchase Orders, Classic Design, Large Format,3 Parts, 1 Color Printing, 8 1/2" x 11", 500/Pack
Item #: 901-D923
Large-format form lists up to 20 procurement items with plenty of space for terms, requisition numbers, stock & shipping information, plus much more
Signature line prevents unauthorized purchases
Create clean records: Carbonless forms stay tightly aligned for clear, clean copies
Custom Appointment Excuse Slips, 4" x 5-1/2", 100 Sheets per Pad
Item #: 901-QFN131551R
Excuse forms for appointments
4" W x 5-1/2" L
White 20# text stock; printed in black ink