Vilonia, AR - Hoosier OTS Mask for Soccer Player

Order Confirmation

Thank you for your order, Julie Sxxxxxxx. Your order number is: 3629 Date of order: 3/29/2013 9:04 PM Shipping Method: FedEx 2Day® Payment Method: Credit card payment
Ship To Julie Stephens 50 Barnard Lane Vilonia, AR 72173 United States Phone:(501)XXX-XXXX
Additional Information Diagnosis: Broken Nose / Soccer
Product Information
Product Name Part No. Quantity Item Price Total Price CLYDE'S HOOSIER MASKS - NO VISION OBSTRUCTION - EASY TO USE - WORLDWIDE SHIPPING Select A Model: OTS - Broken Nose Only What is the injury?: Broken Nose Only Measurement A: Inside ear to ear across tip of nose.: 11 1/2" (11.5 inches) Measurement B: Top of forehead to tip of nose.: 4 3/4" (4.75 inches) Height?: 5'10" (5 feet 10 inches) Weight?: 151 lbs (151 pounds) Sex?: Male Sport?: Soccer I ackknowledge and agree to the terms and conditions of Indiana Brace's Sales and Refund Policy.: Yes L2999 1 $229.00 $229.00 Subtotal: $229.00 Shipping: $25.26 Tax: $0.00 Order Total: $254.26