<%@page import="org.apache.axis.utils.StringUtils"%> <%@ page language="java" contentType="text/html; charset=ISO-8859-1" pageEncoding="ISO-8859-1" import="java.util.List,com.csp.form.SuppliesForm,com.csp.response.SuppliesResponse,com.csp.common.CommonConstants"%> <%@ taglib uri="/tags/struts-html" prefix="html"%> <%@ taglib uri="/tags/struts-bean" prefix="bean"%> <%@ taglib uri="/tags/struts-logic" prefix="logic"%> <%@ taglib prefix="c" uri="http://java.sun.com/jsp/jstl/core" %>

Home > For Physicians & Hospitals >Client Services> Patient Search

Client Account Information

Client Number		Primary Fax	Not on File
Name		Office Fax
Address

Client supply order form

please note that inactivity for 20 minutes will result in session time out and all orders keyed in but not submitted will be lost

Category	Item Number	UOM	Quantity	Item Description

${data.category}

${data.itemNumber}

${data.UOM}

${data.itemDescription}

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