Monday, June 3, 2013

Kurt M. Orders Hoosier OTS - Basketball / Broken Nose Only

New Order (#3823)
Inbox
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www.indianabrace.com
10:12 PM (19 hours ago)

to me
You have received a new order.

Order Confirmation

Thank you for your order, Kurt M.
Your order number is: 3823
Date of order: 6/2/2013 10:12 PM
Shipping Method: FedEx 2Day®
Payment Method: Credit card payment

Ship To

Kurt M.
XXXX Sxxxxxxxxx Lane
Woodbury, MN 55125
United States


Additional Information

Diagnosis: Broken Nose

Product Information

Product NamePart No.QuantityItem PriceTotal 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.: 10.5 inches
Measurement B: Top of forehead to tip of nose.: 4.5 inches
Height?: 5'6"
Weight?: 130
Sex?: Female
Sport?: Basketball
I ackknowledge and agree to the terms and conditions of Indiana Brace's Sales and Refund Policy.: Yes
L29991$129.00$129.00
$129.00
$21.20
$0.00

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