Equipment Consent Form Client Full Name (Required) Billing Name (Required) Billing Address (Required) Shipping Address (Required) Client Contact (Required) Client Email For pdf: Aadhar Card number Select Equipments Hospital Bed 5 FUNCTION ELECTRIC BED3 FUNCTION ELECTRIC BED2 FUNCTION ELECTRIC BEDBED RECLINERNot Required OXYGEN CONCENTRATOR 5 Litres (Philips)10 Litres (Airceps)Not Required Suction Machine RentalSaleNot Required Air Mattress BubbleTubularNot Required DVT Pump DVT Pump with Cuff(New Cuff)Not Required DVT Cuff (Sale Only) DVT CuffNot Required Pulse Oxymeter - BPL (Sale Only) YesNo IV Stand (Sale Only) YesNo Infusion Pump YesNo Syringe Pump YesNo Cardiac Monitor 5 Para3 ParaNot Required Ventilator Philips- Triology EVOPhilips- Triology 100Philips- A40Resmed- Astral 150Resmed- Stellar 150Not Required Bi-PAP Philips- DS AvapsPhilips- DS SPResmed- Aircurve STResmed- Lumis 150Not Required CPAP Philips- Dreamstation CPAPPhilips- Dreamstation AutoCPAPNot Required Oxygen Concentrator - Battery Operated Philips- Simply GoNot Required Oxygen Cylender 10 Litres50 LitresNot Required BP Instrument YesNo Stethoscope YesNo Wheelchair ManualBattery OperatedNot Required