BiaCare Product Catalog | Page 24
CompreFLEX
P: 866.931.0876
F: 866.931.0052
[email protected]
™
- LITE
ORDER FORM
PO#:
Date:
Company:
Phone:
Contact Name:
Patient Name:
Sex:
Age:
Ht:
Wt:
Bill-To Name & Address:
Ship-To Name & Address:
PRODUCT INFORMATION
LEFT LEG
RIGHT LEG
ACCESSORIES (additional cost):
SIZE:
SIZE:
Cotton Socks (extra pair)
Qty:
LENGTH:
LENGTH:
Compression Stocking
Qty:
ITEM #:
ITEM #:
Strap Extenders
Qty:
(10-15 mmHg with silver fibers)
SIZING CHART & ITEM NUMBERS
COMPREFLEX - LITE
C1
C
B
A
Bottom of
Patella
SMALL
MEDIUM
LARGE
29 - 39
34 - 44
24 - 34
16 - 26
29 - 39
X-LARGE XX-LARGE
46 - 56
54 - 64
46 - 56
54 - 64
29 - 39
40 - 50
34 - 44
39 - 49
44 - 55
21 - 30
26 - 36
31 - 41
36 - 46
34 - 44
40 - 50
REGULAR 1401-UC-BKR 1402-UC-BKR 1403-UC-BKR 1404-UC-BKR 1405-UC-BKR
TALL
1401-UC-BKT 1402-UC-BKT 1403-UC-BKT 1404-UC-BKT 1405-UC-BKT
LENGTH (CM):
REG: 30 - 34
TALL: 34 - 42
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