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	Doran DXL7002-FC Second Scale base 10 x 10 for FC6300 2 x 0.0002 lb SKU: DXL7002-FC In Stock - Ships within 24 hours		$1,235.00	$1,235.00

1	Detecto 6400-C Portable Wheelchair Scale 32 in x 36 in with BT / WiFi - 1000 lb x 0.2 lb SKU: 6400-C In Stock - Ships within 24 hours		$2,563.85	$2,563.85

1	Spirometers T-21A Spirometer Disposable paper mouthpieces, 500 per pack SKU: SPMT21A In Stock - Ships within 24 hours		$30.00	$30.00

		Truck Shipping	$306.20	$306.20


			Total	$4,135.05