Diagram Torso Data

Technomed Custom Made Pressure garments

Order Form (For Pressure Garments Head & Neck Data)
(ALL MEASUREMENTS TO BE TAKEN IN CENTIMETRES)


Enter the value in specific box

# Measurement Required Cms
1.
Circumference Above Eyebrow
2.
Circumference Below Nose
3.
Circumference Around Head at Chin Angle
4.
Circumference of Neck
5.
Length of Nose
6.
Width of Nose
7.
Width of eyes
8.
Length of Ear
9.
Width of Mouth
10.
Chin To mouth
11.
Chin To Eyes
12.
Length of Buccal Cavity
13.
Length Between Circumference



Note:- All the fields below are required to be filled. order form will not be submitted if left blank

Name
Email
Address
Phone
ADDITIONAL INFORMATION
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