Form

Patterson Office Supplies
Manufacturer Item #:VJO-112102-PAT3
Patterson Item #:07-011-2102
Package Quantity: 100/Pkg Material: 20 lb Offset # of Parts: 1 part Product Color: White
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Product Specifications
Package Quantity: 100/Pkg Material: 20 lb Offset # of Parts: 1 part Product Color: White Security Features:
  • The face of each blank lists security features
  • Void pantograph printed in pantone green ink –“Void” appears when photocopied.
  • Opaque “Rx” in upper right corner
  • “West Virginia Security Prescripiton” watermark prints on back of each blank
  • Quantity check-off boxes printed on each blank
  • This prescription may be filled with a generically equivalent drug product unless the words “Brand Medically Necessary” are written, in the practitioner's own handwriting, on this prescription form" printed on each blank.
  • Consecutive numbering available at an additional charge on item 051-1238, call for details.
Design Color: Green Dimensions: 8-1/2" W x 11" H (overall) Software Compatiblity: Eaglesoft and most other softwares