8 1/2" x 11 1/2" - 5 part carbonless form with a stub at the top
with Canary NCR paper on all parts. The patient ID carbonizes on all
copies with space for four different orders that will each carbonize
individually. The physicians writes the first order on the Original Copy
, which carbonizes on Order 1
(Part 2) only. Order 1
is then removed from the set and sent directly to the Pharmacy - all other copies remain in the chart. Subsequent orders (Order 2
, and 4
) are handled the same way while the original remains in the chart for future documentation.
These are sold only in boxes of 200 forms each.