V I S I C O I LT M
Linear Fiducial Marker
Phone: 805·499·9951
O R D E R
Above the Rest...
F O R M
Fax: 805·498·7551
Online: www.fiveonestarmedical.com
BILLING INFORMATION
SHIPPING INFORMATION
(if diff erent from Billing)
Business Name:
Business Name:
Address:
Doctor:
City:
Address:
Contact:
City:
State:
Zip:
State:
Phone:
Phone:
Need By Date:
E-mail:
P.O. Number:
Zip:
Fax:
CONF IGURATION AND QUANT IT Y
PRELOADED COILS IN NEEDLES WITH PRE-WAXED TIP
VC-035-010-PL
VC-035-020-PL
VC-035-030-PL
TM
0.35mm Visicoil
0.35mm Visicoil
TM
0.35mm Visicoil
TM
marker - 1.0cm, 20cm NDL
marker - 2.0cm, 20cm NDL
marker - 3.0cm, 20cm NDL
VC-050-005-PL
0.50mm Visicoil
TM
VC-050-005-PL30
0.50mm Visicoil
TM
marker - 0.5cm, 30cm NDL
VC-050-010-PL
0.50mm Visicoil
TM
marker - 1.0cm, 20cm NDL
VC-050-010-PL30
0.50mm Visicoil
TM
marker - 1.0cm, 30cm NDL
VC-075-005-PL
0.75mm Visicoil
marker - 0.5cm, 20cm NDL
TM
marker - 0.5cm, 12cm NDL
TM
marker - 0.5cm, 30cm NDL
VC-075-005-PL30 0.75mm Visicoil
TM
marker - 1.0cm, 20cm NDL
TM
marker - 1.0cm, 12cm NDL
0.75mm Visicoil
VC-075-010-PL12 0.75mm Visicoil
TM
VC-075-010-PL30 0.75mm Visicoil
VC-075-020-PL
0.75mm Visicoil
TM
marker - 1.0cm, 30cm NDL
marker - 2.0cm, 20cm NDL
TM
marker - 2.0cm, 30cm NDL
VC-075-020-PL30 0.75mm Visicoil
VC-075-030-PL
0.75mm Visicoil
TM
marker - 3.0cm, 20cm NDL
VC-110-005-PL
1.10mm Visicoil
TM
marker - 0.5cm, 20cm NDL
VC-110-010-PL
1.10mm Visicoil
COMMENTS:
marker - 0.5cm
0.35mm Visicoil
TM
marker - 1.0cm
0.35mm Visicoil
TM
marker - 2.0cm
0.35mm Visicoil
TM
marker - 3.0cm
FP-05005
0.50mm Visicoil
TM
marker - 0.5cm
FP-05010
0.50mm Visicoil
TM
marker - 1.0cm
FP-0755
0.75mm Visicoil
TM
marker - 0.5cm
0.75mm Visicoil
TM
marker - 1.0cm
0.75mm Visicoil
TM
marker - 2.0cm
0.75mm Visicoil
TM
marker - 3.0cm
FP-0009
FP-0010
FP-0011
FP-0016
FP-0017
0.35mm Visicoil
FP-11005
FP-0057
FP-0058
FP-0059
TM
marker - 0.5cm
1.10mm Visicoil
TM
marker - 1.0cm
1.10mm Visicoil
TM
marker - 2.0cm
1.10mm Visicoil
TM
marker - 3.0cm
1.10mm Visicoil
VISICOIL IMPLANTATION NEEDLES
FP-0048
19ga. introducer needle, 20cm
(for use with 0.35mm coils)
FP-0049
18ga. introducer needle, 20cm
marker - 1.0cm, 20cm NDL
marker - 1.0cm, 30cm NDL
FP-004912
18ga. introducer needle, 12cm
TM
marker - 2.0cm, 20cm NDL
FP-0050
17ga. introducer needle, 20cm
TM
marker - 2.0cm, 30cm NDL
FP-0060
17ga. introducer needle, 30cm
1.10mm Visicoil
1.10mm Visicoil
TM
marker - 3.0cm, 20cm NDL
QTY
EACH
QTY
EACH
LOOSE COILS
TM
VC-110-020-PL30 1.10mm Visicoil
VC-110-030-PL
TM
FP-03505
TM
VC-110-010-PL30 1.10mm Visicoil
VC-110-020-PL
NEEDLE CARRIER LOADED COILS
FP-0015
TM
VC-075-005-PL12 0.75mm Visicoil
VC-075-010-PL
marker - 0.5cm, 20cm NDL
QTY
EACH
(for use with 0.75mm coils)
(for use with 0.75mm coils)
(for use with 1.10mm coils)
(for use with 1.10mm coils)
QTY
EACH