IP Library Granted Patent US 12,227,019
Granted Patent B1
US 12,227,019 · App. 18/306,865 · Granted Feb 18, 2025

Duplex printable combo form with wristband and labels

Inventors: Roger Kraft (Fort Scott, KS); Gina Staudinger (Louisburg, KS); Luke Bukowski (Fort Scott, KS)
Assignee: Rekon, LLC
B42D15/0053G09F3/005B42P2221/06B42P2241/22
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Quick Facts
Patent No.
US 12,227,019
App. No.
18/306,865
Granted
Feb 18, 2025
Kind
B1
Abstract

A business form may include a first ply and a second ply coupled thereto, each ply having an upper portion and a lower portion. A wristband is die cut into the second ply upper portion and releasably secured to the first ply, the wristband having a printable central portion and a strap portion. A plurality of compound elements is located in the second ply lower portion, each compound element comprising a release liner area and a die cut label area, the label area having an alert label disposed thereon, the alert label being bounded by the release liner area. A plurality of chart labels are disposed on the first ply lower portion, the chart labels being releasably secured to the form.

Claims (33)

1. A business form comprising:

a first ply having a first ply upper portion and a first ply lower portion;

a second ply coupled to the first ply, the second ply having a second ply upper portion and

a second ply lower portion;

a wristband die cut into the second ply upper portion, the wristband having a central portion and a strap portion, the wristband being releasably secured to the first ply upper portion;

a printable area disposed on the central portion;

a plurality of compound elements located in the second ply lower portion, each compound element of the plurality of compound elements comprising a release liner area and a die cut label area, the label area having an alert label disposed thereon, the alert label being bounded by the release liner area; and

a plurality of chart labels disposed on the first ply lower portion, the plurality of chart labels being releasably secured to the form:

wherein:

the second ply lower portion is made of polyester;

at least a portion of the first ply lower portion is made of paper; and

the plurality of compound elements is generally offset from the plurality of chart labels, such that each of the plurality of compound elements acts as a liner for multiple chart labels.

2. The form of claim 1 , further comprising a layer of adhesive and a layer of release material located such that the chart labels and the alert labels are independently releasably secured to the form.

3. The form of claim 1 , wherein the plurality of compound elements is configured to act as a liner for the plurality of chart labels by being in substantial alignment with the plurality of chart labels.

4. The form of claim 1 , wherein the second ply upper portion further comprises a die cut wristband extender.

5. The form of claim 1 , further comprising a selection of blood labels in one of the first ply and the second ply.

6. A medical form for conveying information related to a medical patient, the form comprising:

a first side having a first side upper portion and a first side lower portion;

a second side having a second side upper portion and a second side lower portion;

a wristband wearable by a medical patient, the wristband being die cut into the second side upper portion, the wristband having a central portion and a strap portion;

a first printable area disposed in the central portion on the first side;

a plurality of alert labels disposed on the second side, each of the plurality of alert label corresponding to a characteristic of a user and being selectively detachable from the form; and

a plurality of chart labels disposed on the first side lower portion, each of the plurality of chart labels being releasably secured to the form;

wherein:

at least the second side upper portion is made of polyester;

wherein the plurality of alert labels comprise polyester, and wherein each of the plurality of alert labels generally corresponds to and is aligned with a chart label of the plurality of chart labels.

7. The form of claim 6 , wherein the plurality of alert labels is made of polyester.

8. The form of claim 6 , wherein the plurality of alert labels is made of paper.

9. The form of claim 6 , wherein the plurality of alert labels is configured to receive printable indicia.

10. The form of claim 6 , further comprising a second printable area disposed on the central portion of the wristband on the second side.

11. The form of claim 10 , wherein the first printable area is made of paper.

12. The form of claim 10 , wherein at least one of the first printable area and the second printable area is comprised of a polyester ply and a printable coating applied to the polyester ply.

13. The form of claim 6 , further comprising indicia disposed on the plurality of alert labels, wherein the indicia is at least one of a medical test result and a barcode.

Assignments (1)
ASSIGNMENT OF ASSIGNOR'S INTEREST Recorded Apr 26, 2023
From: STAUDINGER, GINA; BUKOWSKI, LUKE; KRAFT, ROGER
To: REKON, LLC
Reel/Frame 063445/0573 →
Continuity (1)
Provisional Application 63363557 · Apr 25, 2022
References Cited (2)
US 20090193701A1 · Greer · 2009 [cited by examiner]
US 20120210620A1 · Jain · 2012 [cited by examiner]