Client Full Name (Required)

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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