Technomed Custom Made Pressure garments

Order Form
Note:- Please fill the details as per the labels marked in the corresponding image. i.e. 1,12 etc.
(ALL MEASUREMENTS TO BE TAKEN IN CENTIMETRE'S)


For Hand Data

Keys                     Circumference
 Left Right
1.
 Wrist
2.
Palm
3.
Thumb
4.
Index Finger DIP
5.
Index Finger PIP
6.
Middle Finger DIP
7.
Middle Finger PIP
8.
Ring Finger DIP
9.
Ring Finger PIP
10.
Little Finger DIP
11.
Little Finger PIP
 Z1:               Z2:
Keys                          Length
Left
Right
12. Little Finger to Web Between Little and Ring Finger's
13. Ring Finger to Web Between Ring
and Middle Finger
14. Middle Finger to Web Between Middle and Index Finger
15. Index Finger to Web Between
Middle and Index Fingers
16. Thumb to Thumb Web
17. Wrist to Web Between Little and Ring Fingers
18. Wrist to Web Between Middle and Ring Fingers
19. Wrist to Web Between Index and Middle Fingers
20. Wrist to Thumb Web

Note:- All the fields below are required to be filled.
( Your order form will not be submitted if left blank)
NAME :
E-MAIL :
ADDRESS :
PHONE :
ADDITIONAL INFORMATION :
      
reference Diagram hand data1
Zipper position
reference Diagram hand data1
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