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Brand

TOPS(3)

 
Recycled

No(3)

 
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)

 
Form Width

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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