Exam & Record Forms CLINICAL FORMS A B 367-1171 Exam Slips, 5 ⁄2"W x 3 ⁄2"H 1 1 Folds to 8"W x 5"H Back 367-1173 80 Lb. Offset Opaque Stock Front CLINICAL FORMS 8"W x 5"H 8"W x 5"H C D 100-3289 100-1032 Front (2-Sided) Back (see G) Front (2-Sided) Back (see G) 6"W x 4"H 6"W x 4"H F E 100-9512 Front (2-Sided) Back (see G) 100-4073 Front Back (see G) 6"W x 4"H G DENTAL RECORD CARDS * 2-sided forms: A & B printed on sturdy 32 Lb. ledger stock, C-G printed on 110 Lb. index stock * All cards double-sided with back service record * Exam slips made from 30% post-consumer recycled material Description A. Exam Slips B. 80 Lb. Offset Stock C-D. 8"W x 5"H Cards E-G. 6"W x 4"H Cards 100-0324 Qty. 5 Pads/PK 100/PK 100/PK 100/PK Price $22.79 $18.79 $14.99 $12.99 2@ $21.79 $17.79 $13.99 $11.99 5@ $19.79 $15.79 $11.99 $9.99 2-Sided, Front & Back Imprinted Materials: 800.414.0940 8am-5pm (ET) Call To Order: 800.372.4346 8am-9pm (ET) 175http://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%3D1001032%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%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