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)       $51 / $56  
695050 Pouch Blockboard       $76  
695600 Cranial Board       $49  
695100/120 Sternal Roll - 8 1/2" or 10 1/2" (Circle One)       $24  
695150 Dutchmans Footroll       $34  
695200 Flat Bottom Footroll       $37  
695250 Pair Adult Pelvic Blocks(Lloyd)       $68  
695260 Pair DeJarnette Type Adult Pelvic Blocks       $66  
695300 Pair Childs Pelvic Blocks       $47  
695350 Dorsal or Sacral Block       $28  
695500/550 Pillow - 15" or 18" (Circle One)       $40  
695650 Open Bottom Face Plate       $48  
695700 Solid Bottom Face Plate       $40  
695750 Anterior Dorsal Plate       $40  
695760 Low Silhouette Dorsal Plate       $40  
693510/4010 C103 Portable - 20 1/2" or 23 1/2" (Circle One) $22     $410  
694100/4110 C104 or C104A Portable (Circle One) $30     $475 /565  
694120/130 C105 or C105A Portable (Circle One) $26     $420 /510  
694138/139 C108 or C108A Portable (Circle One) $45     $1480/1600  
694153 Activator Portable $45     $715  
694510 Zipper Cover for 103-104-105-108 Activator Type $10     $75  
695785 Pediactric Drop Headpiece       $185  
695790/2 Portable Adult Drop Head - Nw or Wd Base(Circle One)       $210 /240  
695795 Portable Extremity Drop      
$240
 
697600 Masters Spinalyzer $35     $580  
695900

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

      $52  
Minimum Shipping & Handling - $10.00 Per Order

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Items & Prices Subject to Change Without Notice or Obligation