             Model D189 Medical Claim Processor for Windows

 To obtain a registration file and the current version of any
 of the following described software products on 3 1/2" diskette,
 complete this order form with appropriate credit card information
 or send with check or money order to:

                       COM1 SOFTWARE, INC.
                       P.O. Box 482
                       Hudson, Ohio 44236
                       (330) 653-3771

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QUANTITY      DESCRIPTION                         UNIT PRICE     TOTAL
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_____  Model 189 Medical Claim Processor for Windows   $49.00  ________
                                          add 5.75% Sales Tax  ________

                                                       Total   ________
