BiaCare Product Catalog | Page 45
P: 866.931.0876
F: 866.931.0052
[email protected]
- TH
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:
Length:
Length:
Item #:
Item #:
CompreBoot PLUS Size:
CompreBoot PLUS Size:
Cotton Liners (extra pair) Qty:
SIZING CHART & ITEM NUMBERS
MEDAFIT - TH
Gluteal Fold
(or desired length)
SMALL S. MAX MEDIUM M. MAX LARGE L. MAX
XLARGE
F 48 - 58 56 - 66 56 - 66 64 - 74 64 - 74 74 - 84 74 - 84
E 43 - 53 51 - 61 51 - 61 58 - 68 58 - 68 68 - 78 68 - 78
D 38 - 48 46 - 56 46 - 56 53 - 63 53 - 63 63 - 73
C1
32 - 42
37 - 47
42 - 52
29 - 39
34 - 44
39 - 49
C
B
24 - 34
29 - 39
33 - 43
20 - 29
21 - 30
25 - 36
A
SHORT 1201-THS
H
LENGTH (CM)
SHORT: 61 - 71
REG: 71 - 81
TALL: 81 - 91
63 - 73
51 - 61
48 - 58
41 - 51
32 - 42
1202-THS
REG MAX 1201-THRM
TALL 1201-THT
XTALL 1201-THTM
1203-THSM N/A
1203-THR
1202-THRM
1203-THRM N/A
1202-THT
REG 1201-THR
1202-THSM
1202-THR
SHORT MAX 1201-THSM
1203-THS
1204-THS
1203-THT
1204-THT
1202-THTM
1203-THTM
N/A
1204-THR
COMPREBOOT PLUS
SMALL
REGULAR
I 28 - 36
J 22 - 26
K 14 - 18
LONG
28 - 36
MED/LARGE
REGULAR
LONG
39 max 39 max
XL/XXL
REGULAR
LONG
44 max 44 max
22 - 26
30 max 30 max
33 max 33 max
19 - 23
18 - 20
20 - 22
23 - 25
25 - 27
32