NCR Carbonless 3 Part Patient Sign in Forms, HIPAA Approved and Compliant for Confidentiality in All Medical Offices. (Blue)
| Country | USA |
| Brand | Jaxplaza |
| Manufacturer | Jaxplaza |
| Binding | Office Product |
| ItemPartNumber | HIPAASIGNINWPSGN |
| Color | BLUE |
| Size | 8 5x11 inches |
| UPCs | 785555018594 |
| EANs | 0785555018594 |
| ReleaseDate | 0000-00-00 |