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	Tanita WB-800P plus Digital Medical Scale,With Pole 660 x 0.2 lb SKU: WB-800P In Stock - Ships within 24 hours		$739.00	$739.00

1	Convaid CX12 902845-903852 Cruiser Cordura 30 Degree Fixed Tilt Wheelchair - Deep Burgundy SKU: 902845-903852 Out of Stock		$1,876.00	$1,876.00

		Ground, UPS	$0.00	$0.00


			Total	$2,615.00