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FRONT / BACK view	Product Code: UB 04

Description   Insurance Claim Form # UB 04 Laser Sheets 500 or 1000 2 part computer continuous 1000 per box Features Dimensions: 8.5" x 11" Color: White Laser Paper 1 Side (Also available in 2 Part Computer Continuous) Related Items Discharge Summary 2 part NCR # 3711 NCR Labels - History Physical Needed Enteral Feeding Assessment #3859-2 Medicine Cards Labels - HMO Weight Record #3855 Release of Medication # 3399 Elopement Risk Tracking Log #2295

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