Categories: Clinical Forms : Prescription Blanks
070242081_1D

Florida Prescription Blanks – 2 Part, First Part Personalized, Second Part Blank, 5-1/2" W x 4-1/4" H, 100 Sets/Pad, 5 Pads/Pkg

Patterson Office Supplies
Patterson Item #: 024-2065
Mfg Item #: VJO-PTC6-PAT3
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Specifications

# of Parts:
2 part
Design Color:
Blue
Dimensions:
5-1/2" W x 4-1/4" H
Ink Color:
Reflex Blue
Logo:
N
Manufacturer Name:
PATTERSON OFFICE SUPPLIES
Material:
Two-Part carbonless stock; First Part – 20 lb White CB, printed in reflex blue on face and security ink on back. Second Part – 20 lb blank canary CF
Package Quantity:
100 Sets/Pad; 5 Pads/Pkg
Product Color:
White/Yellow
Security Features:
  • The face of each personalized blank lists security features.
  • “Void” pantograph pattern appears when the blank is photocopied.
  • A reverse Rx on each prescription blank.
  • Each blank also has security back printing
  • A batch number printed on each blank
  • Microprint signature lines added on personalized blanks.
  • License is verified before printing of scripts.
  • Consecutive numbering available on personalized blanks for an additional charge call for pricing.
Approved by the Agency for Health Care Administration in accordance with the Florida Medicaid Counterfeit-Proof Prescription Blank Program, meet Florida
State Requirements:
Meets

Legend

Promotion
Auto Free Good
My Catalog
My Catalog (Rep)
On Formulary
On Contract
Prescription
Hazmat-Chargeable
Hazmat-No Charge
MSDS / SDS
Schedule 2 and 2N
Schedule 3, 3N, 4 and 5
List 1
No Freeze
Prices in Green indicate discounted price.