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	Convaid CX18 902594-903857 Cruiser Cordura 30 Degree Fixed Tilt Wheelchair Stroller - Forest Green SKU: 902594-903857 Out of Stock		$2,036.00	$2,036.00

1	Rice Lake 350-10-3MBLE Two Ramp Handrail Digital Wheelchair Scale with BlueTooth - 1,000 lb x 0.2 lb (450 kg x 0.1 kg) SKU: 203910 In Stock - Ships within 24 hours		$2,419.60	$2,419.60

1	Thule 11300102 Spring Stroller - Shadow Grey SKU: 11300102 In Stock - Ships within 24 hours		$399.95	$399.95

1	Seca 4900029 EQ Blood Pressure Monitor Cuff - XXL SKU: 4900029001 In Stock - Ships within 24 hours		$47.00	$47.00

1	Detecto Model 204FWMP Digital Readout With Built In Paper Tape Printer SKU: 204FWMP In Stock - Ships within 24 hours		$1,706.65	$1,706.65

		Truck Shipping	$271.20	$271.20


			Total	$6,880.40