Ub04 Hospital Insurance Claim Form, 8.5 X 11, 1/page, 2,500 Forms

Printed to Government Printing Office standards. OCR ink for scanning. American Medical Association (AMA) approved format.

• Form Quantity : 2,500
• Forms Per Page : 1
• Paper Color(s) : White
• Special Features : For Laser Printers
• Pre-Consumer Recycled Content Percent : 0%
• Total Recycled Content Percent : 0%
• Form Size : 8.5 x 11
• Layout : One Form per Sheet
• Global Product Type : Forms-Insurance
• Ship Class Code : M
• Print and Ruling Color(s) : Red
• Printer Compatibility : Laser
• Post-Consumer Recycled Content Percent : 0%
• Paper Stock : 20 lb

Dimensions & Weight

Weight:

26.00 LBS

Width:

9.25 Inches

Height:

10.25 Inches

Depth:

12.00 Inches

Detailed Specs

MPN:

59870R

Form Quantity:

2,500

Paper Stock:

20 lb

Form Size:

8.5 x 11

Total Recycled Content Percent:

0%

Special Features:

For Laser Printers

Pre-Consumer Recycled Content Percent:

0%

Paper Color(s):

White

Post-Consumer Recycled Content Percent:

0%

Layout:

One Form per Sheet

Print and Ruling Color(s):

Red

Global Product Type:

Forms-Insurance

Printer Compatibility:

Laser

Forms Per Page:

1

Ship Class Code:

M