DigiChart Approved Formats; Laser Scripts

APPROVED FORMAT
MEDICAL SCRIPTS
Manufactured by Micro Format, Inc.

www.RxPaper.com/digichart

STATE APPROVED FORMATS
LASER MEDICAL SCRIPTS

Directory

5-1/2" x 8-1/2" Format:
For use in the State of Indiana
For use in the State of Kentucky
For use in the State of West Virginia
For use in the State of Maine
For use in the State of New Jersey

Special Discount Prices for MicroFormat Clients
To receive Special Prices, you must order from this web page

Sheet Size 5-1/2" x 8-1/2" ~~ 2 scripts per sheet
Perforated 4-1/4" from top edge

INDIANA

ENLARGE
Indiana Format
Item#RxEC503IN
Indiana Format
Prescription Paper
5-1/2" x 8-1/2" 1,000 sheets
$75.00
plus shipping by UPS
To Order

2,500 sheets
$175.50
plus shipping by UPS
To Order

5,000 sheets
$345.00
plus shipping by UPS
To Order

KENTUCKY

ENLARGE
Kentucky Format
Item#RxEC503KY
Kentucky Format
Prescription Paper
5-1/2" x 8-1/2" 1,000 sheets
$75.00
plus shipping by UPS
To Order

2,500 sheets
$175.50
plus shipping by UPS
To Order

5,000 sheets
$345.00
plus shipping by UPS
To Order

WEST VIRGINIA
Recommended
but optional

ENLARGE
West Virginia Format
Item#RxEC503WV
West Virginia
Prescription Paper
5-1/2" x 8-1/2" 1,000 sheets
$75.00
plus shipping by UPS
To Order

2,500 sheets
$175.50
plus shipping by UPS
To Order

5,000 sheets
$345.00
plus shipping by UPS
To Order

MAINE

ENLARGE
Maine Format
Item#RxEC503ME
Maine Format
Prescription Paper
5-1/2" x 8-1/2" 1,000 sheets
$75.00
plus shipping by UPS
To Order

2,500 sheets
$175.50
plus shipping by UPS
To Order

5,000 sheets
$345.00
plus shipping by UPS
To Order

Return to www.RxPaper.com/digichart

E-Mail: Questions send us an e-mail ~ Support@4securitypaper.com
Copyright © 2004-2009 Micro Format, Inc. ~ All Rights Reserved
Micro Format, Inc.
830-3 Seton Court ~ Wheeling, IL 60090
Phone: 847/520-4699 ~ 800-333-0549
Fax 847/520-0197

Sheet Size 5-1/2" x 8-1/2" ~~ 2 scripts per sheet Perforated 4-1/4" from top edge
INDIANA ENLARGE Indiana Format Item#RxEC503IN Indiana Format Prescription Paper 5-1/2" x 8-1/2"	1,000 sheets $75.00 plus shipping by UPS To Order	2,500 sheets $175.50 plus shipping by UPS To Order	5,000 sheets $345.00 plus shipping by UPS To Order
KENTUCKY ENLARGE Kentucky Format Item#RxEC503KY Kentucky Format Prescription Paper 5-1/2" x 8-1/2"	1,000 sheets $75.00 plus shipping by UPS To Order	2,500 sheets $175.50 plus shipping by UPS To Order	5,000 sheets $345.00 plus shipping by UPS To Order
WEST VIRGINIA Recommended but optional ENLARGE West Virginia Format Item#RxEC503WV West Virginia Prescription Paper 5-1/2" x 8-1/2"	1,000 sheets $75.00 plus shipping by UPS To Order	2,500 sheets $175.50 plus shipping by UPS To Order	5,000 sheets $345.00 plus shipping by UPS To Order
MAINE ENLARGE Maine Format Item#RxEC503ME Maine Format Prescription Paper 5-1/2" x 8-1/2"	1,000 sheets $75.00 plus shipping by UPS To Order	2,500 sheets $175.50 plus shipping by UPS To Order	5,000 sheets $345.00 plus shipping by UPS To Order