Chickasha, OK - Hoosier OTS Face Mask Broken Nose Only

Order Confirmation

Thank you for your order, SharlynXxxxxx Your order number is: 3635 Date of order: 4/1/2013 2:23 PM Shipping Method: FedEx Priority Overnight® Payment Method: Credit card payment
Ship To CHICKASHA, OK 73018 United States Phone:405XXXXXXX
Additional Information Diagnosis: Broken Nose
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" Measurement B: Top of forehead to tip of nose.: 5" Height?: 5'5" Weight?: 130 Sex?: Female 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: $61.02 Tax: $0.00 Order Total: $290.02