UB04 Hospital Insurance Claim Form 8 1/2 x 11 2,500 Forms
R 4,343
or 4 x payments of R1,085.75 with
Availability: Currently in Stock
Delivery: 10-20 working days
UB04 Hospital Insurance Claim Form 8 1/2 x 11 2,500 Forms
Printed to Government Printing Office standards. OCR ink for scanning. American Medical Association AMA approved format. Form Size: 8 1/2 x 11 Forms Per Page: 1 Form Quantity: 2500 Layout: One Form per Sheet.