BiaCare Product Catalog | Page 9

P: 866.931.0876 F: 866.931.0052 [email protected] - ARM ORDER FORM PO#: Date: Company: Phone: Contact Name: Patient Name: Sex: Age: Ht: Wt: Bill-To Name & Address: Ship-To Name & Address: PRODUCT INFORMATION ARM: Left HAND OPTIONS (see page 42) Right Check One: SIZE: MedaHandā„¢ (Included) MedaGloveā„¢ (Upcharge) Dorsal Pocket Glove (Upcharge) LENGTH: Hand OverSleeve (Upcharge) ITEM #: Size: Glove OverSleeve (Upcharge) Item #: SIZING CHART & ITEM NUMBERS MEDAFIT - ARM C B1 B A Circumference at AXILLA Circumference at Circumference at LEFT MID BICEP RIGHT ELBOW LENGTH SHORT: 38 - 43 REGULAR: 43 - 48 LONG: 48 - 53 SHORT SMALL MEDIUM LARGE X-LARGE 22 - 30 26 - 34 35 - 44 20 - 27 24 - 31 30 - 39 28 - 35 14 - 17 15 - 18 16 - 19 18 - 20 23 - 32 28 - 37 33 - 43 39 - 49 32 - 39 1201 - SHO - L 1202 - SHO - L 1203 - SHO - L 1204 - SHO - L REGULAR 1201 - REG - L 1202 - REG - L 1203 - REG - L 1204 - REG - L LONG 1201 - LNG - L 1202 - LNG - L 1203 - LNG - L 1204 - LNG - L SHORT 1201 - SHO - R 1202 - SHO - R 1203 - SHO - R 1204 - SHO - R REGULAR 1201 - REG - R 1202 - REG - R 1203 - REG - R 1204 - REG - R LONG 1201 - LNG - R 1202 - LNG - R 1203 - LNG - R 1204 - LNG - R HAND SIZING CHART Circumference at WRIST E (Palm) A (Wrist) SMALL 15 - 19 14 - 20 RIGHT 1201 - H - R LEFT 1201 - H - L 19 - 22 16 - 22 LARGE 22 - 26 18 - 24 X-LARGE 1202 - H - R 1202 - H - L 1203 - H - R 1203 - H - L 1204 - H - R 1204 - H - L MEDIUM 26 - 29 20 - 26 8