Pay in 4 interest-free payments of $18.75 Learn more
Ships within 48 hours · Estimated delivery Aug 24 - Aug 29
Size: 10" x 12"
Single sided form includes Medical Alert box for highlighting important medical information
The Dispatch Ticket #3 comes standard with one color
they attach to the original patient exam records
Examination Record DDS, Vertical #1057V HVAC Service Plan Brochure Size: 10" x 12"Record every detail of adult and primary dentition in a horizontal format ideal for file envelopes. Front features tooth charts with 1 32 numbering and a t lettering, with a summary area for patient history. Back includes space for listing services and fees. Formatted for vertical 2 hole punch. Printed on sturdy ledger stock. Size: 8 1 2 x 11"
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