EXAM & RECORD FORMS A B CLINICAL FORMS 367-1171 Exam Slips, 51⁄2”W x 31⁄2”H Folds to 8"W x 5"H 367-1173 8”W x 5”H C D 80 Lb. Offset Opaque Stock 8”W x 5”H 100-3289 6”W x 4”H Front (2-Sided) Back (see H) 100-1032 6”W x 4”H F Front (2-Sided) Back (see H) E 100-2984 Front (2-Sided) Back (see H) 100-9512 6”W x 4”H H Front (2-Sided) Back (see H) G 6”W x 4”H 100-4073 Front Back (see H) 100-0324 Description A. Exam Slips B. 80 Lb. Offset Stock C–D. 8”W x 5”H Cards E–H. 6”W x 4”H Cards 2-Sided, Front & Back DENTAL RECORD CARDS • 2-Sided forms: A & B printed on sturdy 32 Lb. ledger stock, C–H printed on 110 Lb. index stock • All cards double sided with back service record • Exam slips made from 30% post-consumer recycled material Qty. 5 Pads/PK 100/PK 100/PK 100/PK Price $21.99 $17.99 $14.99 $12.99 2@ $20.99 $16.99 $13.99 $11.99 5@ $18.99 $14.99 $11.99 $9.99 Imprinted Materials: 1-800-414-0940 8am–5pm (et) Dental: 1-800-372-4346 8am–9pm (et) 129http://www.henryschein.com/redirect.aspx?did=dental&returnurl=/us-en/Shopping/ProductDetails.aspx%3Fproductid%3D3671171%26CatalogName%3DDENTAL http://www.henryschein.com/redirect.aspx?did=dental&returnurl=/us-en/Shopping/ProductDetails.aspx%3Fproductid%3D3671173%26CatalogName%3DDENTAL http://www.henryschein.com/redirect.aspx?did=dental&returnurl=/us-en/Shopping/ProductDetails.aspx%3Fproductid%3D1003289%26CatalogName%3DDENTAL http://www.henryschein.com/redirect.aspx?did=dental&returnurl=/us-en/Shopping/ProductDetails.aspx%3Fproductid%3D1001032%26CatalogName%3DDENTAL http://www.henryschein.com/redirect.aspx?did=dental&returnurl=/us-en/Shopping/ProductDetails.aspx%3Fproductid%3D1002984%26CatalogName%3DDENTAL http://www.henryschein.com/redirect.aspx?did=dental&returnurl=/us-en/Shopping/ProductDetails.aspx%3Fproductid%3D1009512%26CatalogName%3DDENTAL http://www.henryschein.com/redirect.aspx?did=dental&returnurl=/us-en/Shopping/ProductDetails.aspx%3Fproductid%3D1004073%26CatalogName%3DDENTAL http://www.henryschein.com/redirect.aspx?did=dental&returnurl=/us-en/Shopping/ProductDetails.aspx%3Fproductid%3D1000324%26CatalogName%3DDENTAL http://www.henryschein.com