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Fritz Stephan GmbHMedizintechnikKirchstraße 1956412 GackenbachGermany
Tel. +49 +6439-91 25-0Fax +49 +6439-91 [email protected]
Order form EasyFlow nCPAP
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No. Description Size Article-No. Order
1 Prong, sterile, packing unit 5 pcs. XXS 1 701 61 007 XS 1 701 61 006 S 1 701 61 001 M 1 701 61 002 L 1 701 61 003 XL 1 701 61 004
2 Mask, sterile, packing unit 5 pcs. XS 1 701 61 005 S 1 701 61 012 M 1 701 61 013 L 1 701 61 014 XL 1 701 61 015
3 Extension Mask/Prong, sterile, packing unit 5 pcs. 1 701 61 000
4 Applicator with magnet and pressure sealing cap, packing unit 5 pcs. 1 701 61 161
5 Decoupling tube set, sterile, packing unit 5 pcs. 010 mm 1 701 63 408 Decoupling tube set, sterile, packing unit 5 pcs. (F&P) 012 mm 1 701 63 409 Decoupling tube set, sterile, packing unit 5 pcs. (Leoni/F&P) 012 mm 1 701 63 410
6 Fixing straps for headbands, packing unit 10 pcs. micro/mini 1 701 63 063 maxi 1 701 63 064 Fixing straps for bonnets, with hook-and-loop fastener, packing unit 10 pcs. 1 701 63 071
7 Forehead support (bonnets) 1 701 63 051 Forehead support (headband) 1 701 63 065
8 Cushioned forehead pad with silicone gel, packing unit 5 pcs. 1 701 61 018 Cushioned forehead pad, packing unit 5 pcs. 1 701 61 017
Fritz Stephan GmbHMedizintechnikKirchstraße 1956412 GackenbachGermany
Tel. +49 +6439-91 25-0Fax +49 +6439-91 [email protected]
Order form EasyFlow nCPAP
Buyer:
Company Address Person in charge
Order No. Email Phone
Date Signature
No. Head circumference Weight Size Article-No. Order
9 20 - 28 cm 500 - 1,350 g micro 1 701 61 040
28 - 36 cm 1,350 - 3,700 g mini 1 701 61 041
36 - 48 cm 3,700 - 8,400 g maxi 1 701 61 042
No. Colour Head circumference Weight Size Article-No. Order
10 20 - 22 cm 500 - 700 g XS 1 701 61 019
22 - 24 cm 700 - 900 g S 1 701 61 020
24 - 26 cm 900 - 1,200 g M 1 701 61 021
26 - 28 cm 1,200 - 1,600 g L 1 701 61 022
28 - 30 cm 1,600 - 2,400 g XL 1 701 61 023
30 - 33 cm 2,400 - 3,000 g XXL 1 701 61 024
33 - 36 cm 3,000 - 4,200 g 3XL 1 701 61 025
36 - 39 cm 4,200 - 6,000 g 4XL 1 701 61 026
39 - 42 cm 6,000 - 7,300 g 5XL 1 701 61 027
42 - 45 cm 7,300 - 8,800 g 6XL 1 701 61 028
45 - 48 cm > 8,800 g 7XL 1 701 61 029
Head band with forehead pad and 2 fixing straps (in combination with cushioned forehead pad only)
Bonnets (delivered including forehead support and straps)
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No. Description Size Article-No. Order
Template mask and prong size 1 701 60 020 Measuring tape for head circumference and body length 1 701 60 074
