Patient Transfer Form 880/3
SKU
MPSBRG-880/3
In stock
| MPN | 880/3 |
|---|---|
| Packaging | 1 per each |
| Size | 8 1/2In x 11In |
$218.23
Note : Image shown for reference purposes only. Actual product appearance may vary. Please read product description for full and accurate details
Developed by the Associated Hospital Service of New York, this form provides all the necessary patient information for the receiving facility when transferring a patient. The 3rd ply provides an extra copy for your Medicare intermediary.
Also available:
2-partcarbon interleaved (Stock No. 880/2)
2-part carbonless (Stock No. 879/2)
Also available:
2-partcarbon interleaved (Stock No. 880/2)
2-part carbonless (Stock No. 879/2)
Carbon interleaved; 8 1/2" x 11" detached; white original, color-coded copies; black ink; packaged in 250s.
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