Model: STANDARD FORM 112

Printed Form

Properties:

Identification Designator

Std form 112

Document Title

Request for medical examination

Interleaved W/carbon Paper Feature

Not included

Sheet Width

8.000 inches

Sheet Length

10.500 inches

NSN

7540-00-634-4059

Part Number

STANDARD FORM 112

Description

Form,printed

CAGE

80244

A printed or typed sheet form document with blank space or spaces for insertion of specific information. Excludes card, tabulating, electric accounting machine; paper, tabulating machine, continuous flat fold; paper, graph; indicating slip, dictating machine; envelope (as modified); label; chart (as modified) and tag (as modified).

Part STANDARD FORM 112 NSN 7540-00-634-4059

INC

FIIG

Concept No.

App. Key

Cond. Code

Status

INC:

05403

FIIG:

T393-D

Concept No.:

App. Key:

Cond. Code:

Status:

Material Classification

Hazardous material, precious metals, criticality, enviroment, and electrostatic discharge indicators

HMIC

PMIC

ESD/EMI

ENAC

MMAC

CRITL

HMIC:

PMIC:

ESD:

MMAC:

CRITL:

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Schedule B and Export

Schedule B: 4911990000
SITC: 89289
End Use: Books, printed matter
NAICS: 323111
USDA: 1

Freight Class: Printed matter, nesoi