Checks & Forms Manufactured in the USA 120 Medical Laser Billing Statements Features • Blue or Burgundy • 81/2" x 11" • 20 lb. White laser bond with micro-perforation for ease of printing, opening and remittance • Change of address/insurance backprint • 500 per package • Optional: “We accept” - Mastercard/Visa - Mastercard/Visa/Discover - Mastercard/Visa/Discover/American Express backprint Item Number Description Color 500 1,000 2,500 5,000 10,000 VWH-HF13-NS24 Generic laser statement Blue $39.63 $56.14 $113.93 $208.04 $411.12 Popular Pick! VWH-HF14-NS24 Generic laser statement (MC/VISA) Best Seller! Blue $39.63 $56.14 $113.93 $208.04 $411.12 VWH-HF17-NS24 Generic laser statement (MC/VISA/DISC) Blue $39.63 $56.14 $113.93 $208.04 $411.12 A. VWH-HF18-NS24 Generic laser statement (MC/VISA/DISC/AMEX) Blue $39.63 $56.14 $113.93 $208.04 $411.12 B. VWH-HF19-NS24 Generic laser statement Burgundy $39.63 $56.14 $113.93 $208.04 $411.12 VWH-HF16-NS24 Generic laser statement (MC/VISA) Burgundy $39.63 $56.14 $113.93 $208.04 $411.12 VWH-HF15-NS24 Generic laser statement (MC/VISA/DISC) Burgundy $39.63 $56.14 $113.93 $208.04 $411.12 (R) Production time: 1 working day. 2000 per carton. Medical Laser Billing Statement PLEASE RETURN TOP PORTION WITH YOUR PAYMENT, RETAIN BOTTOM PORTION FOR YOUR RECORDS WLCS107-BK £ Please P box if above address information is incorrect & indicate changes on reverse side. Please see back of form WE ACCEPT FORM: WLCS108-BK SY11230 P42456 11 x 8.5 9/23/13 CRS pms208 BURGANDY (Grad Screen 0 - 10%) PLEASE RETURN TOP PORTION WITH YOUR PAYMENT, RETAIN BOTTOM PORTION FOR YOUR RECORDS WLCS108-BK £ Please P box if above address information is incorrect & indicate changes on reverse side. Please see back of form WE ACCEPT Billing Forms are the staple of any medical office. Add a little color to your statements for a more professional looking form. For more customization options , call customer service for a quote. A. B.
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