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	Detecto 6600 Portable Wheelchair Scale 32 in x 40 in - 1000 lb x 0.2 lb SKU: 6600 In Stock - Ships within 24 hours		$2,951.48	$2,951.48

1	Spirometers T-20 Portable Spirometer SKU: SPMT20 In Stock - Ships within 24 hours		$199.90	$199.90

		Truck Shipping	$229.00	$229.00


			Total	$3,380.38