SPARE PARTS
O
RDER FORM

 


 

Authorised Allied Health Care Products Spare Parts Distributor


Print out this form,  fill in and fax to 03 5282 4892


Orderers Name.....................................................................................

Customer/Company Name: ...................................................................

Street Address.......................................................................................

Town/Suburb.......................................................................................

State................................................      Postal Code..............................

Phone (.................)  .................................................

Fax (...............) ........................................................

Email.........................................................................

Ventilation Bags Quantity Patient valves Quantity
87 01 00      Adult Bag 1600ml   56 02 00      Patient Valve  
86 01 00      Child Bag 500ml   85 12 00      Patient Valve with pressure regulator  
85 01 00      Infant Bag 240ml   85 11 03      Lock clips for pressure regulator package of 10  
Masks   85 13 00      Patient valve with pressure regulator and lock clip  
85 15 00      Silicone Mask No. 00   54 01 03      Lip valve  
85 16 00      Silicone Mask No. 0/1   54 01 05      Disk membranes package 10  
85 17 00      Silicone Mask No. 2   Miscellaneous equipment  
86 02 20      Silicone Child Mask No. 3-4   85 05 00      Expiration diverter (OD 30 mm)  
87 02 20      Silicone Adult Mask No. 4-5   85 06 00      Scavenging connector  
85 02 00      Rendell-Baker Type Silicone Mask No. 0   85 10 00      Connector (diverter to Standard tubing)  
85 03 00      Rendell-Baker Type Silicone Mask No. 1   85 09 00      Manometer connector  
85 04 00      Rendell-Baker Type Silicone Mask No. 2   87 04 00      Head strap with attachment ring  
O2 Reservoir Assemblies   87 13 00      Attachment ring for standard head strap  
53 19 01      O2 reservoir 2.6 Litres   87 10 00      Silicone extension tube (28cm)  
55 19 01      O2 reservoir 0.6 Litres   87 01 00      Hand strap  
53 19 02      Reservoir valve unit   87 01 20      Hanging Loop  
87 07 00      Disposable reservoir bags package of 25   51 17 00      Wall bracket  


For Fast Service and Great Pricing

Fax To:


RAPP Australia Pty Ltd  on 03 52824892


Click here to go to Laerdal Silicone BVM Parts Pictures and Parts List