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NEBS

Dental Exam Record Form 8.5 x 11, 100 Count — NEBS Printed Dental Records

Dental Exam Record Form 8.5 x 11, 100 Count — NEBS Printed Dental Records

Regular price $115.99 USD
Regular price $214.99 USD Sale price $115.99 USD
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  • Printed in black ink on 32# white ledger stock
  • Ruled back for additional notes
  • Shrink wrapped 50 per pack (2 pack minimum)

This is our basic dental record with ruled front and back, great for documenting exam or treatment notes and account information. With full front and back sections, these are great for additional patient service notes! The top section includes patient details including insurance data as well as a boldly defined medical Alert section. Columns are: Date, Tooth No., Services Rendered, Account Record which is divided into Charge, Paid and Balance.

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