BiaCare Product Catalog | Page 39
CompreFit
P: 866.931.0876
F: 866.931.0052
[email protected]
®
- BK & TC
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
*
Color:
Length:
Beige
Thigh Component (TC)
Below Knee (BK)
Size:
Black
RIGHT LEG
CompreBoot Size:
Color:
Size:
Beige
Size:
Size:
Item #:
Black
Thigh Component (TC)
Below Knee (BK)
Item #:
Length:
Item #:
*
*
Item #:
CompreBoot Size:
(See page 41 for foot sizing)
if no color is selected, black will be shipped.
(See page 41 for foot sizing)
SIZING CHART & ITEM NUMBERS
COMPREFIT - TC
F
E
D
SMALL
48 - 58
43 - 53
38 - 48
BLACK 1101 - TC
BEIGE 1111 - TC
MEDIUM
56 - 66
51 - 61
46 - 56
64 - 74
58 - 68
53 - 63
LARGE
X - LARGE
1102 - TC
1103 - TC
1104 - TC
1112 - TC
1113 - TC
1114 - TC
74 - 84
68 - 78
63 - 73
BK - REGULAR
C
B
A
SMALL
29 - 39
24 - 34
20 - 29
MEDIUM
34 - 44
29 - 39
21 - 30
LARGE
39 - 49
33 - 43
25 - 36
X - LARGE
48 - 58
41 - 51
32 - 42
XX - LARGE
55 - 65
44 - 55
33 - 43
BLACK 1101 - BKR 1102 - BKR 1103 - BKR 1104 - BKR 1105 - BKR
LENGTH (CM)
REG: 30 - 36
TALL: 36 - 42
BEIGE 1111 - BKR 1112 - BKR 1113 - BKR 1114 - BKR 1115 - BKR
C1
C
B
A
BK - TALL
29 - 39
26 - 36
21 - 31
20 - 29
34 - 44
31 - 41
25 - 35
21 - 30
39 - 49
35 - 45
30 - 40
25 - 36
BLACK 1101 - BKT 1102 - BKT 1103 - BKT
BEIGE 1111 - BKT 1112 - BKT
48 - 58
45 - 55
36 - 46
32 - 42
55 - 65
50 - 60
40 - 50
33 - 43
1104 - BKT 1105 - BKT
1113 - BKT 1114 - BKT 1115 - BKT
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