Order Form
800-398-4726
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PHONE: 516-868-2443
Fax: 516-868-3054
P.O. Box 924, Hicksville, NY 11802
To order an instrument please fill out this form or call 1-800-398-4726
Name:
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Purchase Order #:
Address:
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Quantity
Instrument #
Instrument Name
Copyright © 2006 • 800-398-4726 • Tisco Surgical Instruments • P.O. Box 924 • Hicksville, NY 11802