BiaCare Product Catalog | Page 11
ChipSleeve
P: 866.931.0876
F: 866.931.0052
[email protected]
TM
ORDER FORM
PO#:
- BK
Date:
Company:
Phone:
Contact Name:
Patient Name:
Sex:
Age:
Ht:
Wt:
Bill-To Name & Address:
Ship-To Name & Address:
PRODUCT INFORMATION
LEFT LEG
OVERSLEEVE (included):
RIGHT LEG
SIZE:
SIZE:
Black
Pink
Leopard
LENGTH:
LENGTH:
Navy
Tie-Dye
Purple Paisley
ITEM #:
ITEM #:
Note: If no color is specified, a black
OverSleeve™ will be included.
SIZING CHART & ITEM NUMBERS
Circumference
CHIPSLEEVE - BK
Bottom of Patella
C1
C
B
A
SMALL
MEDIUM
LARGE
29 - 39
34 - 44
24 - 34
20 - 29
32 - 42
REGULAR 2631 - BKR
LENGTH (CM)
REG: 30 - 36
TALL: 36 - 42
TALL
X-LARGE XX-LARGE
51 - 61
58 - 68
48 - 58
55 - 65
29 - 39
39 - 49
33 - 43
41 - 51
44 - 55
21 - 30
25 - 36
32 - 42
33 - 43
37 - 47
42 - 52
2632 - BKR 2633 - BKR 2634 - BKR 2635 - BKR
2631 - BKT 2632 - BKT
2633 - BKT
2634 - BKT
2635 - BKT
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