Instruments for the General and Colorectal Surgeon

 

Prices in US Dollars

 

Model #

Name

Qty

Price

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 
Name ___________________________________________    Buyer ____________________________
 
Address _____________________________________________________________________________
 
City/State/Province ________________________________    Zip/Postal Code, Country _____________
 
Phone ___________________________________  Fax __________________________________   

 

P.O. (required if hospital) ____________________________   Date _____________________________

 

Method of Payment:

 

1.      DOCTORS US and Canada, No advance payment required, fax order, payment due 30 days after delivery

2.      HOSPITALS US and Canada, Purchase orders accepted, no advance approval necessary, payment due 30 days after delivery

3.     Others, Fax request, pro forma invoice will be return faxed with method of payment outlined.

4.     MINIMUMS: International 100.00 USD, USA & Possessions 33.00

 
Mastercard, Visa, American Express ___________________   
 
Credit Card Number _________________________     Expiration Date _________
 
 

Shipping: In US, United Parcel Service ground with charges added to invoice. If air delivery necessary must be authorized at time of order. Outside US, all shipments are via United States Express Postage insured.

 
 

Fax Orders and Inquiries to:

George Percy McGown, 122 Wyckoff Street, Brooklyn, NY 11201

Phone: 954-435-0845, Fax: 954-435-0864