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	Rice Lake D1000-2 Upper Body Composition Analyzer 400 x 0.2 lb SKU: 151114 Available		$2,335.50	$2,335.50

1	Peg Perego - Viaggio Flex 120 Child Booster Seat Licorice SKU: FLEX120LICO In Stock - Ships within 24 hours		$299.99	$299.99

		Ground, UPS	$0.00	$0.00


			Total	$2,635.49