ORDER FORM Please print orderform from our website in order to get the latest edition! Anti-rotational belts EDITION 2 - 120905 Date Customer Order Custom made Already delivered Offer Proforma Days Billing/Delivery address Consultant Tryed out by Prescriber User 900004 Try-out time 900001 Traveling time Hours Hour/dist. Anti-rotational belt size M with DWSR40 art no. 374063 78 Art no. Name 374060 Tongue D-ring Pull direction Hip measure Anti-rotational belt size XS, DWSR25 150 mm Yes Double 15-25 cm 374061 Anti-rotational belt size S, DWSR25 175 mm Yes Double 25-32 cm 374063 Anti-rotational belt size M, DWSR40 195 mm Yes Double 30-37 cm 374064 Anti-rotational belt size L, DWSR40 215 mm Yes Double 35-45 cm 374065 Anti-rotational belt size XS, Chromeline 150 mm Yes Single 15-25 cm 374066 Anti-rotational belt size S, Chromeline 175 mm Yes Single 25-32 cm 374067 Anti-rotational belt size M, Car lock 195 mm Yes Single 30-37 cm 374068 Anti-rotational belt size L, Car lock 215 mm Yes Single 35-45 cm 374075 Anti-rotational belt size M, 742 195 mm Yes Double 30-37 cm 374076 Anti-rotational belt size L, 742 215 mm Yes Double 35-45 cm 374077 Anti-rotational belt size L, 340 (reinforced) 215 mm Yes Single 35-45 cm Support - Order form Hip belts Buckle © Anatomic SITT AB ORDER FORM Please print orderform from our website in order to get the latest edition! Sittbelt Exclusive EDITION 2 - 120905 Date Customer Order Custom made Already delivered Offer Proforma Days Billing/Delivery address Consultant Tryed out by Prescriber User 900004 Try-out time 900001 Traveling time Hours Hour/dist. Sittbelt Exclusive size L with 742 buckle art no. 3791 Art no. Name 3794 Buckle Tongue D-ring Pull direction Hip measure Sittbelt Exclusive size S, 725 150 mm No Single 25-32 cm 3793 Sittbelt Exclusive size L, S40 220 mm No Single 35-45 cm 3792 Sittbelt Exclusive size L, Car lock 220 mm No Single 35-45 cm 3791 Sittbelt Exclusive size L, 742 220 mm No Double 35-45 cm Spare parts 3795 3796 Cushion for Sittbelt Exclusive size S (for 25 mm straps) Cushion for Sittbelt Exclusive size L (for 40 mm straps) © Anatomic SITT AB Support - Order form Hip belts 79 ORDER FORM Please print orderform from our website in order to get the latest edition! Sittbelt Pro EDITION 2 - 120905 Date Customer Order Custom made Already delivered Offer Proforma Days Billing/Delivery address Consultant Tryed out by Prescriber User 900004 Try-out time 900001 Traveling time Hours Hour/dist. Sittbelt Pro size L with 742 buckle art no. 374030 Artn no. Name 374048 Buckle Tongue D-ring Pull direction Hip measure Sittbelt Pro size XS, DWSR25 125 mm Yes Double 15-25 cm 374046 Sittbelt Pro size S, DWSR25 150 mm Yes Double 25-32 cm 374043 Sittbelt Pro size M, DWSR25 190 mm Yes Double 32-37 cm 374038 Sittbelt Pro size L, DWSR40 300 mm Yes Double 35-45 cm 374049 Sittbelt Pro size XS, 725 125 mm Yes Single 15-25 cm 374045 Sittbelt Pro size S, 725 150 mm Yes Single 25-32 cm 374041 Sittbelt Pro size M, 725 190 mm Yes Single 32-37 cm 374031 Sittbelt Pro size L, 740 220 mm Yes Single 35-45 cm 374030 Sittbelt Pro size L, 742 220 mm Yes Double 35-45 cm 374055 Sittbelt Pro size XS, Chromeline 125 mm Yes Single 15-25 cm 374056 Sittbelt Pro size S, Chromeline 150 mm Yes Single 25-32 cm 374042 Sittbelt Pro size M, Chromeline 190 mm Yes Single 32-37 cm 374034 Sittbelt Pro size L, Car lock 220 mm Yes Single 35-45 cm 374036 Sittbelt Pro size M, 340 (reinforced)* 190 mm Yes Single 32-37 cm 374035 Sittbelt Pro size L, 340 (reinforced)* 300 mm Yes Single 35-45 cm 374033 Sittbelt Pro size L, Airplane buckle 220 mm Yes Single 35-45 cm 374032 Sittbelt Pro size L, S40 220 mm Yes Single 35-45 cm * Reinforced with tri-glide buckles in steel. Spare parts 376213 Cushion, Sittbelt Pro size XS (for 25 mm straps) 376215 Cushion, Sittbelt Pro size M (for 25 mm straps) 376214 80 Cushion, Sittbelt Pro size S (for 25 mm straps) Support - Order form Hip belts 376216 376217 Cushion, Sittbelt Pro size L (for 40 mm straps) Cushion, Sittbelt Pro, reinforced (for 40 mm straps) © Anatomic SITT AB ORDER FORM Please print orderform from our website in order to get the latest edition! Sittbelt Comfort Pro EDITION 2 - 120905 Date Customer Order Custom made Already delivered Offer Proforma Days Billing/Delivery address Consultant Tryed out by Prescriber User 900004 Try-out time 900001 Traveling time Hours Hour/dist. Sittbelt Comfort Pro size L with 742 buckle art no. 374050 Art no. Name 374081 Buckle Tongue D-ring Pull direction Hip measure Comfort Pro size XS, DWSR25 125 mm Yes Double 15-25 cm 374052 Comfort Pro size S, DWSR25 150 mm Yes Double 25-32 cm 374080 Comfort Pro size XS, 725 125 mm Yes Single 15-25 cm 374051 Comfort Pro size S, 725 150 mm Yes Single 25-32 cm 374082 Comfort Pro size XS, Chromeline 125 mm Yes Single 15-25 cm 374053 Comfort Pro size S, Chromeline 150 mm Yes Single 25-32 cm 374050 Comfort Pro size L, 742 220 mm Yes Double 35-45 cm Spare parts 376213 Cushion, Sittbelt size XS (for 25 mm straps) 376215 Cushion, Sittbelt size M (for 25 mm straps) 376214 Cushion, Sittbelt size S (for 25 mm straps) © Anatomic SITT AB 376216 376217 Cushion, Sittbelt size L (for 40 mm straps) Cushion, Sittbelt, reinforced (for 40 mm straps) Support - Order form Hip belts 81
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