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	LifeSource 11-007 Medium Bladder for UA-200 Sphygmomanometers SKU: 11-007 In Stock - Ships within 24 hours		$8.99	$8.99

1	Convaid CX10 903314-903855 Cruiser Cordura 30 Degree Fixed Tilt Wheelchair - True Red SKU: 903314-903855 Out of Stock		$1,876.00	$1,876.00

1	Detecto RW-1000 Run-a-Weigh Portable Floor Scales,1,000 lb x 0.5 lb SKU: RW-1000 In Stock - Ships within 24 hours		$1,949.00	$1,949.00

1	Rice Lake 150-10-8 Floor Physician Scale - 550 x 0.2 lb SKU: 224055 In Stock - Ships within 24 hours		$454.25	$454.25

		Truck Shipping	$254.70	$254.70


			Total	$4,542.94