HANDS
order by
for professionals
“One package goes all the way”
Global Online Ordering System
Name patient
dd/mm/yyyy
Date of Birth
Gender
m
. . /. . / . . . .
Measured by
Signature
Date of Measuring
. . / . . / 201 .
f
Contact Person
Department
Circumference
w3
Length
w4
w2
y3
y2
y4
w5
w1
y5
x5
AB
y1
A
x4
B
x3
AC
x1
x2
C
CD
D
UP
PALM
CO01
skin/skin
CO02
skin/black
CO03
SI01
black/black
skin
COMFORT
SILICONE
ST01
skin/skin
ST03
ST06
black/black
ST08
blue/black
green/black
ST09
ST10
red/skin
red/black
STRONG
ST11
ST14
pink/skin
bordeaux/black
ST16
grey/black
ST17
light grey/skin
ST18
light grey/black
ST19
navy blue/skin
ST20
navy blue/black
STRONG
Options:
y1: ......
K0066-2.17-en
closed fingers
half glove
closed thumb
open fingers
(min. length 1.5cm)
halve glove
open thumb
symbol boy
wrist without pressure
symbol girl
with zipper (always on back)
Remarks:
y2: ......
…………………………………………………
y3: ......
…………………………………………………
y4: ......
…………………………………………………
y5: ......
…………………………………………………
glove + arm sleeve in 1 piece
left hand
right hand
nv Tricolast sa - Kortijkstraat 52 - B-9800 Deinze|www.caroskin.eu - [email protected]|GOOSe Online: Free|T + 32(9) 386 15 11 - F + 32(9) 386 16 09 (10€/Fax)
LEGS
order by
“One package goes all the way”
for professionals
Global Online Ordering System
Name patient
dd/mm/yyyy
Date of Birth
Gender
m
. . /. . / . . . .
Measured by
Signature
AM
Date of Measuring
Contact Person
Department
Length
Circumference
M
. . / . . / 201 .
f
E
RIGHT
LEFT
D
C
AL
L
AG
AK
K
B1
G
AG
G
B
V
A2
A1
AA2
AF
H
AF
F
F
sideview
V
A2
A1
H
A
AE
E
E
AE
AD
D
D
AD
AC
C
C
AC
x
xxx
xx
sideview (inside)
AB1
B1
B1
AB1
Right
x
AB
B
B
AB
xx
xx
AA2
A2
A2
AA2
xxx
xxx
H
AA2
Left
x
H
A
CO01
skin/skin
A1
CO02
A1
A
CO03
skin/black
SI01
black/black
SI02
skin
COMFORT
black
SILICONE
ST01
ST03
skin/skin
ST06
black/black
ST08
blue/black
green/black
ST09
red/skin
ST10
red/black
STRONG
ST11
ST14
pink/skin
bordeaux/black
ST16
grey/black
ST17
light grey/skin
ST18
light grey/black
ST19
navy blue/skin
ST20
navy blue/black
STRONG
K0068-2.17-en
Options:
! standard without zipper
toes open (xx)
open zipper
toes closed (xxx)
men zipper
bellypiece without pressure
zipper on front
with anti-slip ribbon
zipper on side
symbol girl
waist drawstring
symbol boy
braces length: .........
Remarks:
Executions:
panty
panty
1 leg
pirate pants
pirate pants
1 leg
bermuda
bermuda
1 leg
leg AG
leg AD
knee
upper leg
calf
ankle
braces
belly
…………………………………….....
…………………………………….....
nv Tricolast sa - Kortijkstraat 52 - B-9800 Deinze|www.caroskin.eu - [email protected]|GOOSe Online: Free|T + 32(9) 386 15 11 - F + 32(9) 386 16 09 (10€/Fax)
ARMS
order by
“One package goes all the way”
for professionals
Global Online Ordering System
Name patient
dd/mm/yyyy
Date of Birth
Gender
m
. . /. . / . . . .
Measured by
Signature
Date of Measuring
. . / . . / 201 .
f
Contact Person
Department
Circumference
RIGHT
Length
LEFT
H
H
GH
GH
I
G
G
N
CG
CG
F
F
CF
CF
E
E
CE
CE
D
D
CD
CD
C
CO01
skin/skin
C
CO02
skin/black
CO03
SI01
black/black
skin
COMFORT
SI02
black
SILICONE
ST01
skin/skin
ST03
ST06
black/black
ST08
blue/black
ST09
green/black
red/skin
ST10
red/black
STRONG
ST11
ST14
pink/skin
bordeaux/black
ST16
grey/black
ST17
light grey/skin
ST18
light grey/black
ST19
navy blue/skin
ST20
navy blue/black
STRONG
Options:
Remarks:
Executions:
….....................……………………………...
with anti-slip ribbon
symbol boy
K0069-2.17-en
symbol girl
….....................………………………………
WRIST CD
glove & arm sleeve in 1 piece
ARM CE
ARM CG
ARM with
shoulder cap
….....................………………………………
….....................………………………………
….....................………………………………
nv Tricolast sa - Kortijkstraat 52 - B-9800 Deinze|www.caroskin.eu - [email protected]|GOOSe Online: Free|T + 32(9) 386 15 11 - F + 32(9) 386 16 09 (10€/Fax)
CHIN RIBBON
order by
for professionals
“One package goes all the way”
Global Online Ordering System
Name patient
dd/mm/yyyy
Date of Birth
. . /. . / . . . .
Measured by
Signature
Gender
m
Contact Person
Date of Measuring
f
. . / . . / 201 .
Department
Circumference
Length
AB
AC
CD
CE
ED
EF
FD
BD
KCK
GH
H*
KD
I
IK
G
K
I
! measures in cm
* H left over head to H right
G
E
H
D
F
F
H
C
B
A
POLYAMIDE
Remarks:
SILICONE
………………………………………..........................................................................................................
K0070-2.17-en
………………………………………........................................................................................................................................
………………………………………........................................................................................................................................
………………………………………........................................................................................................................................
………………………………………........................................................................................................................................
nv Tricolast sa - Kortijkstraat 52 - B-9800 Deinze|www.caroskin.eu - [email protected]|GOOSe Online: Free|T + 32(9) 386 15 11 - F + 32(9) 386 16 09 (10€/Fax)
THORAX
order by
“One package goes all the way”
for professionals
Global Online Ordering System
Name patient
dd/mm/yyyy
Date of Birth
Gender
m
. . /. . / . . . .
Measured by
Signature
Circumference
S
H
A
J
I
Cup
A-B*
A-B*
I-J
I-J
Length
Left
RA
N-R1
N-RA
Collarheight
S
back
Right
R1
N
N
Tc
B
RIGHT
Department
X2
X2
G
. . / . . / 201 .
f
Contact Person
Cup
Length
Date of Measuring
LEFT
S
SH
SH
H
H
SG
SG
H
G
H
NR
Sl
G
N
NN2
CG
CG
N2
F
F
CF
CF
N2M
E
E
M
CE
CE
D
D
ML
CD
CD
L
C
C
CO01
skin/skin
CO02
skin/black
CO03
SI01
black/black
skin
COMFORT
SI02
black
Body
SILICONE
ST01
skin/skin
ST03
ST06
black/black
ST08
blue/black
green/black
ST09
red/skin
standard*
ST10
red/black
L: ....
STRONG
ST11
pink/skin
ST14
bordeaux/black
ST16
grey/black
ST17
light grey/skin
ST18
light grey/black
ST19
navy blue/skin
navy blue/black
L
STRONG
K0067-2.17-en
Options:
opening middle back
………………........................
hook fasteners
with made to measure arm
zip-fastener
………………….....................
without arm compression sleeve
L
*standard child
(l:22, w:4.5 cm)
Remarks:
opening middle front
compression sleeves
B: ....
ST20
obese /pregnant
anti-slip
……...…….............................
symbol boy
……...…….............................
symbol girl
……………….........................
nv Tricolast sa - Kortijkstraat 52 - B-9800 Deinze|www.caroskin.eu - [email protected]|GOOSe Online: Free|T + 32(9) 386 15 11 - F + 32(9) 386 16 09 (10€/Fax)
NIEUW S-LINE
HANDEN
order by
for professionals
“One package goes all the way”
Global Online Ordering System
Name patient
dd/mm/yyyy
Date of Birth
Gender
m
. . /. . / . . . .
Measured by
Signature
Contact Person
Date of Measuring
f
. . / . . / 201 .
Department
Circumference
Length
w3
w4
w2
y3
y2
y4
w5
w1
y5
x5
AB
y1
x4
B
x3
AC
x1
A
x2
C
CD
D
CH02
white/black
PALM
CH03
UP
CH21
zwart/black
white/white
COMFORT-CH
PA01
PA03
skin/white
PA06
black/black
PA08
blue/black
green/black
PA09
red/white
PA10
red/black
STRONG-PA
PA14
PA11
bordeaux/black
pink/white
PA16
grey/black
PA17
light grey/white
PA20
navy blue/black
STRONG-PA
K0066-2.17-nl
closed fingers
open fingers
(min. length 1.5cm)
y1: ......
Remarks:
y2: ......
…………………………………………………
y3: ......
…………………………………………………
y4: ......
y5: ......
hand left
…………………………………………………
…………………………………………………
hand right
nv Tricolast sa - Kortijkstraat 52 - B-9800 Deinze|www.caroskin.eu - [email protected]|GOOSe Online: Free|T + 32(9) 386 15 11 - F + 32(9) 386 16 09 (10€/Fax)