HealthCheckSystems

Billing Address
(As shown on your credit card statement.)
First name * Last name * Company Name Address * Address2 City State\Province: * Zip/Postal Code * Country * Day Phone * Cell Phone Fax Email *
Shipping Address
First name * Last name * Company Name Address * Address2 City * State\Province * Zip/Postal Code * Country * Day Phone * Cell Phone Fax
Payment Info
Name on card * Credit Card number * CVV *

Month *(12) Year*(2025)

Visa MasterCard Amex Discover

Quantity	Name		Price EA	Total

1	CHICCO 06079400950 Layla Tote & Dash Bag- Black SKU: 06079400950 In Stock - Ships within 24 hours		$89.99	$89.99

1	Detecto 475 Mechanical Medical Chair Scale, 400 lb x 4 oz SKU: 475 Available - Ships Within 24 Hours		$664.05	$664.05

1	HealthOMeter 64771 Scale Carrying Case SKU: 64771 In Stock - Ships within 24 hours		$87.00	$87.00

		Truck Shipping	$289.50	$289.50


			Total	$1,130.54