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 *(05) Year*(2024)

Visa MasterCard Amex Discover

Quantity	Name		Price EA	Total

1	Detecto 6495 Digital Wheelchair Scale, 800 lbs x 0.2 lb SKU: 6495 In Stock - Ships within 24 hours		$2,758.69	$2,758.69

1	Rice Lake, 45885 ASTM Class 0 Metric Density 2.7 Leaf Weight Kits with Accredited Certificate 1mg SKU: 45885 In Stock - Ships within 24 hours		$256.75	$256.75

		Truck Shipping	$273.00	$273.00


			Total	$3,288.44