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 OverSleeveā„¢ 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 10