Material Handling Solutions Llc 
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Product Categories:
  • Abrasives
  • Adhesives, Sealants and Tapes
  • Barriers
  • Bins
  • Breakroom and Janitorial
  • Cabinets
  • Cafeteria Tables
  • Canopies/Shelters
  • Cantilever Racks
  • Carts
  • Casters
  • Chairs & Stools
  • Chemicals, Lubricants and Paints
  • Cleaners / Wipes
  • Commercial Laundry Machines
  • Containers
  • Conveyors
  • Cranes
  • Desks / Tables
  • Display Shelving
  • Dock Equipment
  • Dollies
  • Drums & Equipment
  • Electrical and Lighting
  • Electrical Tools
  • Fans & Heaters
  • Fasteners, Clamps and Straps
  • Forklifts
  • Hand Tools
  • Hand Trucks
  • Hoists & Equipment
  • Hose & Cord Reels
  • HVAC
  • Janitorial Equipment
  • Janitorial Supplies
  • Ladders
  • Lifts
  • Lifts / Lifting Equipment
  • Lockers
  • Marking Tools
  • Material Handling
  • Matting
  • Measuring and Leveling Tools
  • Mezzanines
  • Miscellaneous
  • Mobile Cabinets
  • MRO Supplies
  • Office Furniture
  • Office Supplies
  • Oilfield
  • Pallet Racks
  • Pallet Trucks
  • Pallets & Equipment
  • Plastic Pallets
  • Plumbing Equipment
  • Pneumatics
  • Power Tools
  • Pumps
  • Rack Systems
  • Safety and Security
  • Safety Equipment
  • Scales
  • Shelving
  • Shipping Supplies
  • Shop Desks & Tables
  • Strobe Lights
  • Tables & Table Movers
  • Tape
  • Technology
  • Tilt Trucks & Hoppers
  • Tool Control
  • Tools
  • Trucks
  • Used Forklifts
  • Warehouse Equipment
  • Welding Supplies
  • Wipes & Cleaners
  • Wire Partitions
  • Work Benches



  • Tops® Ub04 Hospital Insurance Claim Form printable version

       
    Product No. TOP59870R
    Global Product Type Forms-Insurance Claim
    Form Type Insurance Claim
    Format Loose Form
    Form Size (W x H) 8 1/2 in x 11 in
    Form Size 8 1/2 x 11
    Forms Per Page 1
    Sheet Size 8 1/2 X 11
    Form Quantity 2500
    Layout One Form per Sheet
    Punching
    Printer Compatibility Laser
    Paper Stock 20-lb.
    Paper Color(s) White
    Print and Ruling Color(s) Red
    Form Special Features For Laser Printers
    Pre-Consumer Recycled Content Percent 0 %
    Post-Consumer Recycled Content Percent 0 %
    Total Recycled Content Percent 0 %
    CT $186.97
    Quantity  

     

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