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Non-Dot Form Three Part Form

Product # : 927457 Class : MCKSN Distributor : RELIANCE INC Category : Forms Availability : Please contact customer service at info@RxReliance.com to check availability.

Non-Stock Item Information : Any reason may apply

This item ships directly from the manufacturer. Additional shipping charges may apply.
As a special order from the supplier, the approximate delivery time is 2-4 weeks.
For equipment such as beds, lifts, etc., a freight code is required. Please reach out to us to get the code.

$0.00

Product Notices : This product may be non-returnable and/or require additional restocking fee.

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$54.51

Product Specifications

Product No. #	927457
Manufacturer #	14008
Manufacturer	Lifeloc Technologies
Country of Origin	United States
Application	Non-Dot Form
Shipping Width	11.5
Shipping Height	2
Shipping Depth	8.5
Dimension UOM	IC
Shipping Weight	2.4
Weight UOM	LB
Color	Yellow
QTY_Per_Sell	1
Type	Three Part Form
Simply_Medical_Category	Forms
Supply_Manager_Category	Forms
Supply_Manager_Hierarchy	Nurse's Station and Office Supplies>Forms>Non-Dot Form
Legend_Code	No
Stock_Status	NonStock
Velocity	Slow Selling

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Non-Dot Form Three Part Form

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Non-Dot Form Three Part Form