<PAGE>
UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
FORM 10-C
REPORT BY ISSUER OF SECURITIES QUOTED ON NASDAQ
INTERDEALER QUOTATION SYSTEM
FILED PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
AND RULE 13a-17 OR 15d-17 THEREUNDER
MICRO BIO-MEDICS, INC.
- --------------------------------------------------------------------------------
(Exact name of issuer as specified in charter)
846 Pelham Parkway, Pelham, Manor, New York 10803
- --------------------------------------------------------------------------------
(Address of principal executive offices)
Issuer's telephone number, including area code 914 738-8400
----------- --------------------
I. CHANGE IN NUMBER OF SHARES OUTSTANDING
Indicate any change (increase or decrease) of 5% or more in the number of shares
outstanding:
1. Title of security Common Stock, $.03 par value
-----------------------------------------------------------
2. Number of shares outstanding before the change 3,694,163
------------------------------
3. Number of shares outstanding after the change 3,869,163
------------------------------
4. Effective date of change September 28, 1995
----------------------------------------------------
5. Method of change:
Specify method (such as merger, acquisition, exchange, distribution, stock
split, reverse split, acquisition of stock for treasury, etc.)
Debenture Conversion
----------------------------------------------------------------------------
Give brief description of transaction $1,500,000 principal amount of
---------------------------------------
outstanding debentures were converted at $8.00 per share into 187,500 shares
----------------------------------------------------------------------------
II. CHANGE IN NAME OF ISSUER
1. Name prior to change
--------------------------------------------------------
2. Name after change
-----------------------------------------------------------
3. Effective date of charter amendment changing name
---------------------------
4. Date of shareholder approval of change, if required
-------------------------
Date October 5, 1995 /s/ Stuart P. Fleischer
-------------------------------------- ----------------------------------
(Officer's signature & title)
Stuart P. Fleischer
Vice President-Finance
and Chief Financial Officer
SEC 1811 (5/91)
