Final answer:
Each horizontal box on ECG paper indicates a duration of 0.04 seconds or 40 milliseconds.
Step-by-step explanation:
An electrocardiogram (ECG) paper contains a standardized grid where the horizontal axis measures time and the vertical axis measures voltage or amplitude. Each horizontal box on the ECG paper indicates a duration of 0.04 seconds or 40 milliseconds. This allows medical professionals to accurately measure and analyze the electrical activity of the heart.