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 *(05) Year*(2024)

Visa MasterCard Amex Discover

Quantity	Name		Price EA	Total

1	Thule 20201510 Stroller Cup Holder/Bottle Cage - Open Box SKU: 20201510 Open Box Out of Stock		$20.00	$20.00

1	Quinny CV298BQZ Yezz Stroller Seat Cover Purple Rush SKU: CV298BQZ In Stock - Ships within 24 hours		$55.99	$55.99

1	Health O Meter 2500KL Digital Wheelchair Scale, 1000 lx 0.2 lb SKU: 2500KL In Stock - Ships within 24 hours		$2,691.00	$2,691.00

1	Peg Perego - IMVF00US35MX53DX13 Viaggio Flex 120 Child Booster Seat - John Deere (Black/Green) SKU: IMVF00US35MX53DX13 In Stock - Ships within 24 hours		$299.99	$299.99

1	Seca 472 Stand For Scale Display and Measuring Rods SKU: 4720000004 In Stock - Ships within 24 hours		$189.00	$189.00

		Truck Shipping	$1,793.00	$1,793.00


			Total	$5,048.98