Order Form

Quantity	Item #	Item Description	Price
	B101	Multi-ModalityTM Biopsy Tray - 20/case	$319.00
	B102	Stereotactic Biopsy Tray - 10/case	$365.00
	FA201A	AccuFitTM Siemens/Fischer® Autoguide Drape - 25/case	$376.25
	FT301	AccuFitTM Siemens/Fischer® Table Cover - 25/case	$148.75
	LS601	AccuFitTM Lorad® Table Drape System-20/case	$200.00
	LS701	AccuFitTM Lorad® Stage Drape System-20/case	$220.00
	US401	Ultrasound Biopsy Drape	Coming Soon
	MDS092005	Ultrasound Gel, 9oz bottles - 12/case	$20.25
	MDS092010	Ultrasound Gel, 5 Liter Jug - 4/case	$57.60
	MGE48H	AccuFitTM MRI Headrest Disposable Cover - 100/Case	$149
	INV4C	AccuFitTM MRI 4 Channel Breast Coil Disposable Cover - 50/Case	$89.50
	INV78C	AccuFitTM MRI 7 & 8 Channel Breast Coil Disposable Cover - 200/Case	$738
	MT201A	MRI "Non-ferro magnetic" Tray - 10/Case	$460
	TDS701	MRI "Non-ferro magnetic" Disposable Scalpel - 4/pkg	$100
	IN904	MRI "Non-ferro magnetic" Needle 22g 9cm - 4/pkg	$100
	DYNJP2405	Utility Drapes w/Tape, 2 per pack - 100 pk/case	$67.60
	DYNJSM03	Fine Tip Skin Marker with Ruler - 50/case	$49.15
	LBLBLANK	Sterile Blank Labels, 10 labels/sheet - 200/case	$224.00
	LBLSTND	Sterile Pre-printed + 4 Blank Labels, 31 labels/sheet - 200/case	$275.00
	NON28233F	HAIR/BOUFFANT CAPS, Butterfly Print, 21 inch - 500/case	$87.50
	NON28952	Non-Skid Shoe Covers - 200 per case	$52.00

Purchase Order #:
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	(Order confirmation will appear)

Appropriate shipping charges will be added.
Pricing subject to change without notice.
PRICES EFFECTIVE 01/01/2006

You may also fax your original P.O. to 720-304-2512