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Physicians Telephone Orders Form

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1 – 4$112.10
5 – 9$104.60
10 – 14$89.80
15 +$75.10
SKU: 989P


Features three individual snap-out-style telephone orders per 8 1/2" x 11" page with an 8 1/2" x 11" mount sheet attached. Routing is as follows:

·         ORIGINAL COPY - Physician Please Sign and Return

·         PHARMACY COPY - Send to Pharmacy

·         CHART CONTROL COPY - Attach Original Signed Copy When Received

All detachable parts are perforated between the three telephone order forms for easy individual removal.

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Each slip measures 8 1/2" x 3 1/4", printed in black and red ink on carbonless paper, white original, color-coded copies and canary mount sheets, 5 holes punched top and left, packaged in 125s.

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