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Form HC5 - Refund Claim form
ARCHIVAL ITEMS
form
National Health Service
Europe: United Kingdom, England
April 2003
paper
overall: 300 mm x 210 mm

NHS form HC5 for patients to claim back the cost of NHS treatment including for a sight test, glasses or contact lenses. A4 portrait format printed in light and dark blue and light and dark red, on four sides of white paper, folded. 2 examples.


2019.546

Gift of Mr John Dixon Salt FCOptom, 2019



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