Order for Stockings

NAME OF PERSON

ADDRESS

REFD BY (DOCTOR)

DIAGNOSIS

SIDE FOR WHICH GARMENT IS REQUIRED

Left Right Both

Number of garments (Tick Choice) Single / Pair / More (pl Specify)

Payment Details :

How to measure:

How to measure

See Chart as below using reference points as shown in figure on the left.

Mark points at various points in the leg using 0 as the cross in the ankle.
Put the site with a minus sign (negative) if going towards the toes. - enter this measurements in cm in Column 1 above
Using an ordinary tape enter the relevant circumference in columns 2 and 3 in cms against the relevant site as measured.
The Ankle has to be always measured (put 0 in the site column)
The knee should be marked as K and also mentioned in distance from Ankle (column 1) measure it only if above knee stocking required.

(payment for Orders possible through HDFC

Bank in your town. - call us for Bank Account number and related costs for each variant
Stockings will be dispatched within 2 working days of receipt of order by courier.

Use this measuring chart if the tape is not available else the tape can be sent
Site Position in Cm From Ankle Turn (Use - for foot)	AFFECTED SIDE (Left if Both) Circumference in Cm	NORMAL SIDE (Right if Both) Circumference in Cm (3)
-
-
-
-
-
-
0	45
5
10
15
20
25
30
35
40
45
50
55
65
70
75