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Communicate information regarding new admissions, room changes, discharges or deaths to all necessary departments with Briggs Form 1236.
8 1/2" x 7" (detached), white paper, color-coded copies, black ink 1236/3: Communication 3-Part Form, 250/pack 1236/4: Communication 4-Part Form, 250/pack 1236/5: Communication 5-Part Form, 125/pack

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Communication Form 1236/5