Maggie - Lockport, NY - X1 RTL Blade/Sesamoiditis

New Order (#3763) Sesamoiditis - X1 RTL

X1 Blade RTL

www.indianabrace.com	11:06 AM (4 hours ago)

Order Confirmation

Thank you for your order, Maggie Rxxxxxx. Your order number is: 3763 Date of order: 5/10/2013 11:06 AM Shipping Method: USPS Priority Mail Payment Method: Credit card payment
Ship To Maggie Rxxxxxx 4X5 Lxxxxx Street Lockport, NY 14094 United States Phone:716-XXX-3XX0
Additional Information Diagnosis: sesamoiditis need for running
Product Information
Product Name Part No. Quantity Item Price Total Price Clyde's X1 Blade RTL for the Treatment of Hallux Limitus or Rigidus with Bone Spurs and Sesamoiditis Foot: Right Size: Women's 11 Men's 10 / 27 CM What is your injury?: Sesamoiditis I acknowledge and agree to the terms and conditions of Indiana Brace's Sales and Refund Policy.: Yes TL-501HL 1 $129.50 $129.50 Subtotal: $129.50 Shipping: $5.85 Tax: $0.00 Order Total: $135.35