Spinal Equipment - Medical Online

ias

M E D I C A L P R O D U C T S

DATE:_____________________________ORDER NUMBER:________________________

TO: Immediate Assistants P/L

PO Box 1503

Neutral Bay

NSW 2089

Phone/Fax ORDER TO: 0500 888 020

2 Page FAX

EMAIL ORDER TO: #9; ado@ias.com.au

CONTACT DETAILS AND DELIVERY INSTRUCTIONS:

________________________________________________

AUTHORISED BY: ЕЕЕЕЕЕЕЕЕЕ..ЕЕЕЕЕ.(name)

..ЕЕЕ.ЕЕ....Е.ЕЕЕЕЕЕ.(position)

ЕЕЕЕЕЕЕ..Е..ЕЕЕЕЕЕЕ.(sign)

SPINAL EQUIPMENT ORDER FORM

quantity	ITEM No.	DESCRIPTION	UNIT PRICE	TOTAL PRICE
	SN1	Single Cervical Collar Size:	$40	$
	SN6	Set of 6 Cervical Collars in Carry Bag	$250	$
	SN7	Adjustable Collar (All adult sizes)	$65	$
	SS1	Scoop Stretcher (aluminium)	$1,650	$
	SS2	Combi Scoop Stretcher (plastic)	$1,650	$
	SB1	Spine Board with straps (floating)	$1.100	$
	HB1	Head Bed	$550	$
	SL1	Stokes Litter and Flotation Kit	$1,550	$
	VM1	Vacuum Mattress and Pump	$1.150	$
	AED1	Adult Extrication Device	$1,350	$
	PED1	Paediatric Extrication Device	$1,150	$
	ES1	Extrication Stretcher plus lifting kit	$3,900	$
	FR1	Overnight Freight	$40	$40
			TOTAL	$

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