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Brand

TOPS(3)

 
Recycled

No(3)

 
Manufacturer Part Number

50126RV(1)

50135RV(1)

59870R(1)

 
Country of Origin

United States(3)

 
Sheet Size

11" Width x 8.50" Length(1)

 
Print Color

Red(3)

 
Basis Weight

20 lb(2)

 
Number of Parts

1(2)

 
Form Length

8.50"(1)

11"(1)

 
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11"(1)

8.50"(1)

 
Printed Side

Front(1)

 
Product Type

Health Insurance Form(2)

Claim Form(1)

 
Product Model

UB-04(1)

 
Sheet Color

White(1)

 
 
 

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