ORTHOFEET, INC
152A Veterans Dr., Northvale, NJ 07647SHOE ORDER FORM – F18 P: 800-524-2845 F: 201-767-6748 E: Orders@Cust. No:P.O. #:Date:Contact:Bill To:Ship To:Address: Address:Address:Address:City:City:State:Zip:State:Zip:Tel:Fax:Email:Men’s styles are available in sizes: 7, 7?, 8, 8?, 9, 9?, 10, 10?, 11, 11?, 12, 13, 14ModelPattern NameModelPattern NameModelPattern NameModelPattern NameModelPattern NameModelPattern Name410***Avery Island481Highline521Tacoma585Lincoln Center619Lava651Ventura420Avery Island487Highline525**Bismarck587Lincoln Center640*Pacific Palisades672Sprint422Baton Rouge489Hunter571Melbourne593Alpine641Pacific Palisades674Sprint427Baton Rouge510**Broadway572Melbourne598Alpine642SorrentoS331^Asheville461 Jackson Square517 Carnegie573Clearwater610**Monterey Bay644Shreveport334^Hudson465 Gramercy520Broadway581 Glacier Gorge611**Monterey Bay650Ventura467Gramercy617**Edgewater *Available also in Narrow (N=B) width **Available in size 15 and XX Wide (XXW=6E) width*** Available also in Narrow, XXW and size 15 ^Available in M and W OnlyMen’s styles available in Medium (M=D), Wide (W=2E) & Extra Wide (XW=4E) widths.Women’s styles are available in sizes: 5, 5?, 6, 6?, 7, 7?, 8, 8?, 9, 9?, 10, 10?, 11, 11?, 12ModelPattern NameModelPattern NameModelPattern NameModelPattern NameModelPattern NameModelPattern Name111^ Dina 701**Lake Charles851Chattanooga 872Sarasota Beach893Sanibel973Verve112^Dina810**Acadia853Chattanooga 875 Naples895Sanibel975Verve 113^Maya817*Chelsea854Bristol877Chickasaw896 Serene981Coral 115^Maya819Chelsea Croc857Oakridge882 Delta898Sanibel982Sandy 117^Lily825**Wichita859Chattanooga883Naples910**Tahoe986 Coral121^Vera 826**Springfield863Athens885Milano911**Tahoe987Coral122^Aviva827** Springfield865* Celina 887Tivoli916**Tahoe991Verona223^Marina832Joelle869 Athens888Florence940**Whitney997Verona231^Natalya835Breeze871 Sarasota Beach891Serene941**WhitneyS731^Charlotte241^Emma839Narine944Sonoma732^Louise*Available also in Narrow (N=A) ** Available in XXW (XXW=4E)*** Available in Narrow and XXW ^Available in Med and Wide Only Women’s styles available in Medium (M=B),Wide (W=D) & Extra Wide (XW=2E) widths.STYLEWIDTHSIZE# OF INSOLESINSOLE TYPEPATIENT NAME/REFERENCE NUMBERInsole Choice: Retail (OGI) - A5512 Coded Diabetic (TDI) - Email Sales@ for Custom Diabetic Information ................
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