ORTHODONTICS - Star Dental Supply
ORTHODONTICS - Star Dental Supply
ORTHODONTICS - Star Dental Supply
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<strong>ORTHODONTICS</strong><br />
TEMPRA BAND FORM<br />
SHIP TO:<br />
BILL TO:<br />
SHIPPING INSTRUCTIONS:<br />
SEND CATALOG<br />
CUSTOMER #<br />
632936<br />
LINGUAL<br />
ATTACHMENTS<br />
BICUSPID<br />
BLANK<br />
CLEAT<br />
SHIP DATE CODE<br />
89<br />
1st MOLAR<br />
BLANK<br />
LUG<br />
LUG BUTTON CLEAT<br />
SOURCE<br />
ea<br />
2nd MOLAR<br />
BLANK<br />
LUG<br />
CLEAT<br />
BUTTON<br />
SHEATH<br />
ETCH<br />
ORDERED BY %<br />
ORDER TYPE<br />
SIGN OFF<br />
PAYMENT ORDER DATE<br />
ORDER COMMENTS:<br />
0<br />
PLAIN BANDS ONLY<br />
BRACKET SLOT SIZE .018 .022<br />
FACEBOW TUBE SIZE .045 .051<br />
CATALOG NUMBER<br />
UPPER BICUSPID<br />
- 5 R<br />
- 5 1st<br />
2nd<br />
L<br />
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24<br />
TOTAL<br />
0<br />
0<br />
CATALOG NUMBER<br />
LOWER BICUSPID<br />
- 5 R<br />
- 5 1st<br />
2nd<br />
L<br />
3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26<br />
TOTAL<br />
0<br />
0<br />
CATALOG NUMBER TEMPRA BAND 29.5 30 30.5 31 31.5 32 32.5 33 33.5 34 34.5 35 35.5 36 36.5 37 37.5 38 38.5 39 39.5 40 40.5 41 41.5 42 42.5 43 43.5 44 TOTAL<br />
- UPPER R 4 8 8 8 8 8 8 8 8 8 8 4 4 4 4 4 4 4 4 4 4 4<br />
- 1st MOLAR L 4 4 4 4 4 8 8 8 8 8 8 8 8 8 8 8 8 4 4 4 4 4 4 4 4 4 4 4<br />
- UPPER R<br />
- 2nd MOLAR L<br />
- LOWER R<br />
- 1st MOLAR L<br />
- LOWER R<br />
- 2nd MOLAR L<br />
378
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