LLOYD TABLE COMPANY ORDER FORM
102-122 West Main Street P.O. Box 899 Lisbon, IA 52253
800.553.7297 319.455.2166 email: sales@lloydtable.com

Part# Description Ship Color Qty Price Total
695000/025 DeJarnette Blockboard-16" x 20" or 17" x 21"(Circle One)       $48 / $53  
695050 Pouch Blockboard       $72  
695600 Cranial Board       $46  
695100/120 Sternal Roll - 8 1/2" or 10 1/2" (Circle One)       $23  
695150 Dutchmans Footroll       $32  
695200 Flat Bottom Footroll       $35  
695250 Pair Adult Pelvic Blocks(Lloyd)       $64  
695260 Pair DeJarnette Type Adult Pelvic Blocks       $62  
695300 Pair Childs Pelvic Blocks       $44  
695350 Dorsal or Sacral Block       $26  
695500/550 Pillow - 15" or 18" (Circle One)       $38  
695650 Open Bottom Face Plate       $45  
695700 Solid Bottom Face Plate       $38  
695750 Anterior Dorsal Plate       $38  
695760 Low Silhouette Dorsal Plate       $38  
693510/4010 C103 Portable - 20 1/2" or 23 1/2" (Circle One) $20     $385  
694100/4110 C104 or C104A Portable (Circle One) $27     $450 /510  
694120/130 C105 or C105A Portable (Circle One) $22     $395 /455  
694138/139 C108 or C108A Portable (Circle One) $40     $1420/1500  
694153 Activator Portable $40     $675  
694510 Zipper Cover for 103-104-105-108 Activator Type       $75  
695785 Pediactric Drop Headpiece       $175  
695790/2 Portable Adult Drop Head - Nw or Wd Base(Circle One)       $200 /225  
695795 Portable Extremity Drop      
$225
 
697600 Masters Spinalyzer $27     $545  
695900

Crepe Headrest Paper, 25 rolls/carton, 125ft/roll

      $42  
Minimum Shipping & Handling - $10.00 Per Order

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Items & Prices Subject to Change Without Notice or Obligation