The Medical Store 108 N. Dwyer Ave. Arlington Hts, IL 60005 847-670-0778 Fax: 847-253-3967
Website: www.themedicalstore.biz e-mail: [email protected]
SHIP TO ADDRESS
Student Name____________________________________________
BILL TO ADDRESS (REQUIRED IF PAYING BY CREDIT/DEBIT CARD)
Name________________________________________________________
Street Address, Apt#_______________________________________
StreetAddress,Apt#____________________________________________
City, State, Zip__________________________________________
City, State, Zip_________________________________________________
Telephone____________________________ Medical School_____________________________E-mail____________________________________
SOUTH UNIVERSITY PA PROGRAM
Package Price
Welch Allyn Student Economy Diagnostic Set
265.00
Educational Value Pack (Pocket Eye Chart, Practice Eye, Ear Speculum, reference Guide Book) Free with Diagnostic Set
Insuflator Bulb for Otoscope
7.50
Disposable Ear Speculumn (Adult & Pediatric)
2.00
BP Cuff DS44-11C Economy DuraShock Hand Aneroid with Adult Cuff
42.00
Reusable Welch Allyn Pediatric Cuff
22.00
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Littmann Cardiology III Stethoscopes: Circle Color
152.00
Black__ Burgundy__ Navy Blue__ Hunter Green__ Plum__ Chocolate__ Gray__ Red__ Raspberry__ Coral Pink__ Ceil Blue__ Caribbean Blue__
SPECIAL FINISH COLORS (add $17.00)
Black/BrassFinish($17 more) Chocolate/CopperFinish($17 more) Black/SmokeFinish($17 more) Black/RainbowFinish($17 more)
AllBlackEdition ($17 more) Olive/SmokeFinish($17 more) Sand/SmokeFinish($17 more) Turquoise/SmokeFinish($17 more)
Lemon-Lime/SmokeFinish($17 more) Lavender/RainbowFinish($17 more)
Stethoscope includes Student Accessory Kit valued at $45.00 (Kit includes name tag, extra ear tips and a CD of actual heart sounds)
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Miscellaneous Items:
15-1314
15-1316
83210
260
12700
35-780
25-779
62
C-128 Tuning Fork
C-512 Tuning Fork
Taylor Hammer
Penlight AAA Batteries
Monofilament Touch Test
Tape Measure
EKG Ruler
Goniometer 6”
7.50
7.50
2.50
4.50
24.00
3.00
5.25
5.75
Equipment Package Total $550.50
Upgrade to 97200MCL Welch Allyn Diagnostic set
Upgrade to 97800MCL Welch Allyn PanOptic Diagnostic set
add $239.00
add $523.00
Total Due To The Medical Store
Checks payable to: THE MEDICAL STORE
Visa Master Card Discover
Card No ___________________________
Check #__________
Cash__________
EXP DATE _________________
Signature _________________________
CID/Verification code ________
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