quote - d&j compression · p0175reva quote credit card info customer name customer no. purchase...
Post on 22-Jan-2020
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P017
5Rev
A
Quote
Credit Card Info
Customer Name Customer No. Purchase Order No. Fax
juxtafit™ premium
circa
id®
inel
astic
com
pres
sion
garm
ents
Boot Only
graduate™
classicflex™
Left QuantityLower Extremity
Notes:
power added compression band™ (default)
juxtafit™ premium ankle foot wrap
juxtafit™ premium interlocking ankle foot wrap
single band ankle foot wrap™
Standard foot options
graduate foot optionboot attached (default)boot separate
Foot Options Cover up color
black (default)
beige
juxtafit™ premium ankle foot wrapattached separate
Made-to-measure foot option
Foam liner color options:Interior: beige (default) red turquoise
Exterior: black (default) beige red turquoise
QuantityRight
no boot
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