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Hip Guide Form C
(Please attach to Generic Order Form)
Name: ________________ Company:_____________________ Ref:___________________
BRACKET OPTIONS (Hip pads can be mounted onto armrest stems if applicable)
PAD ONLY (NO BRACKETS) FIXED ADJUSTABLE QUICK RELEASE
FIXED BRACKETING
STANDARD LENGTH OPTIONS
Part No. 1153 1401
(A) WIDTH (B) LENGTH QTY
12” 80mm
14” 90mm
16” 100mm
17” 100mm
18” 100mm
20” 120mm
(Page 17)
QUICK RELEASE BRACKETING
Part No. 1153 1402
O
CUSTOM PAD DIMENSIONS
(A) = (D) =
(B) = (E) =
rder Form
(C) =
s
Form C
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