Physician Assistant Institute: Student Equipment Order Form / Accounts Payable / Purchasing / By Prathyusha Jaddu "*" indicates required fields Name* First Last UB ID* Phone*Email* Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code EquipmentOpthalmoscope/Otoscope 1188031 – 71-SM2CXX – Diagnostic Sys, Ophthalmoscope/otoscope W/accessories – $526.51 1188031 – 71-SM2CXX – Diagnostic Sys, Ophthalmoscope/otoscope W/accessories – $526.51 Price: Stethoscopes 1012629 6151 Stethoscope, Litt Cardio Iv Blk 22 – $172.34 1013785 6152 Stethoscope, Litt Cardio Iv Blk 27 – $172.34 1013788 6154 Stethoscope, Litt Cardio Iv Nvy Blu 27 – $172.34 1013791 6156 Stethoscope, Litt Cardio Iv Plum 27 – $172.34 1013793 6158 Stethoscope, Litt Cardio Iv Rasberry 27 – $172.34 1137485 6201 Stethoscope, Cardiology Iv Littmann W/blk Tubing/blu Stem – $196.77 1137482 6200 Stethoscope, Cardiology Iv Littmann W/blk Tubing/red Stem – $196.77 1137487 6203 Stethoscope, Cardiology Iv Littmann W/blk Tubing/violet Stem – $196.77 1049064 6165 Stethoscope, Cardiology Iv Rainbow Blk Tu 27 – $196.77 1037999 6163 Stethoscope, Cardiology Iv W/blk Finish – $196.77 1053108 6168 Stethoscope, Litt Cardio Iv W/blk Bell Navy Blu – $196.77 1062301 6179 Stethoscope, Cardiology Iv Blkchampagne/smoke Finish 27 – $210.54 1062298 6177 Stethoscope, Cardiology Iv Blkmirror Finish 27 – $210.54 1137490 6204 Stethoscope, Cardiology Iv High Polish Smoke/blk Tubing – $210.55 1151532 6232 Stethoscope, Cardiology Iv Littmann Blk Tu Blk Headset 27 – $210.54 1151535 6240 Stethoscope, Cardiology Iv Littmann Blk Tu Smoke Headset 27 – $210.54 1151531 6238 Stethoscope, Cardiology Iv Littmann Gry Tu Smoke Hdset 27 – $210.55 1151536 6242 Stethoscope, Cardiology Iv Littmann Nvy Blu Blk Headset 27 – $210.54 1106539 6170 Stethoscope, Littman Cardiology Iv Mirror-Finish Burg 27 – $210.54 1106542 7100212911 Stethoscope, Littmann Cardiology Iv Burg/champagne Finish – $210.54 1012629 6151 Stethoscope, Litt Cardio Iv Blk 22 – $172.34 Price: 1013785 6152 Stethoscope, Litt Cardio Iv Blk 27 – $172.34 Price: 1013788 6154 Stethoscope, Litt Cardio Iv Nvy Blu 27 – $172.34 Price: 1013791 6156 Stethoscope, Litt Cardio Iv Plum 27 – $172.34 Price: 1013793 6158 Stethoscope, Litt Cardio Iv Rasberry 27 – $172.34 Price: 1137485 6201 Stethoscope, Cardiology Iv Littmann W/blk Tubing/blu Stem – $196.77 Price: 1137482 6200 Stethoscope, Cardiology Iv Littmann W/blk Tubing/red Stem – $196.77 Price: 1137487 6203 Stethoscope, Cardiology Iv Littmann W/blk Tubing/violet Stem – $196.77 Price: 1049064 6165 Stethoscope, Cardiology Iv Rainbow Blk Tu 27 – $196.77 Price: 1037999 6163 Stethoscope, Cardiology Iv W/blk Finish – $196.77 Price: 1053108 6168 Stethoscope, Litt Cardio Iv W/blk Bell Navy Blu – $196.77 Price: 1062301 6179 Stethoscope, Cardiology Iv Blkchampagne/smoke Finish 27 – $210.54 Price: 1062298 6177 Stethoscope, Cardiology Iv Blkmirror Finish 27 – $210.54 Price: 1137490 6204 Stethoscope, Cardiology Iv High Polish Smoke/blk Tubing – $210.55 Price: 1151532 6232 Stethoscope, Cardiology Iv Littmann Blk Tu Blk Headset 27 – $210.54 Price: 1151535 6240 Stethoscope, Cardiology Iv Littmann Blk Tu Smoke Headset 27 – $210.55 Price: 1151531 6238 Stethoscope, Cardiology Iv Littmann Gry Tu Smoke Hdset 27 – $210.55 Price: 1151536 6242 Stethoscope, Cardiology Iv Littmann Nvy Blu Blk Headset 27 – $210.54 Price: 1106539 6170 Stethoscope, Littman Cardiology Iv Mirror-Finish Burg 27 – $210.54 Price: 1106542 7100212911 Stethoscope, Littmann Cardiology Iv Burg/champagne Finish – $210.54 Price: Lab Coats 1046523 175-XS-8135158 Coat, Lab Consultation Wht Ml Xsm D/s – $18.38 1046524 175-S-8135158 Coat, Lab Consultation Wht Ml Sm D/s – $18.38 1046525 175-M-8135158 Coat, Lab Consultation Wht Ml Med D/s – $18.38 1046526 175-L-8135158 Coat, Lab Consultation Wht Ml Lg D/s – $18.38 1046527 175-XL-8135158 Coat, Lab Consultation Wht Ml Xlg D/s – $18.38 1046528 175-2XL-8135158 Coat, Lab Consultation Wht Ml 2xlg D/s – $22.06 1046523 175-XS-8135158 Coat, Lab Consultation Wht Ml Xsm D/s – $18.38 Price: 1046524 175-S-8135158 Coat, Lab Consultation Wht Ml Sm D/s – $18.38 Price: 1046525 175-M-8135158 Coat, Lab Consultation Wht Ml Med D/s – $18.38 Price: 1046526 175-L-8135158 Coat, Lab Consultation Wht Ml Lg D/s – $18.38 Price: 1046527 175-XL-8135158 Coat, Lab Consultation Wht Ml Xlg D/s – $18.38 Price: 1046528 175-2XL-8135158 Coat, Lab Consultation Wht Ml 2xlg D/s – $22.06 Price: Medical Tools 803197 01-775-11ANGM Sphyg, Aneroid Std Lf Nvy Adlt(1/bx) Mgm01 – $16.76 256825 3693 Hammer, Taylor Percussion Org 7 1/2 Amdiag – $2.81 157508 19-106 Tuning Fork, Aluminum Alloy C512 Miltex – $11.96 1110134 43-1-102 Fork, Tuning C-128 W/weights – $17.33 193987 22-6666 Penlight, W/pupil Gauge Disp (6/pk) – $12.51 1038451 63-3053 Chart, Eye Test Pckt Lf 6 1/2 x3 1/2 (5/bg) – $17.89 1174258 V61-0101PT Gown, Exam Pt Cloth Adlt Blu (12/dz) – $49.14 803197 01-775-11ANGM Sphyg, Aneroid Std Lf Nvy Adlt(1/bx) Mgm01 – $16.76 Price: 256825 3693 Hammer Taylor Percussion Org 7 1/2 Amdiag – $2.81 Price: 157508 19-106 Tuning Fork, Aluminum Alloy C512 Miltex – $11.96 Price: 1110134 43-1-102 Fork, Tuning C-128 W/weights – $17.33 Price: 193987 22-6666 Penlight, W/pupil Gauge Disp (6/pk) – $12.51 Price: 1038451 63-3053 Chart, Eye Test Pckt Lf 6 1/2 x3 1/2 (5/bg) – $17.89 Price: 1174258 V61-0101PT Gown, Exam Pt Cloth Adlt Blu (12/dz) – $49.14 Price: TotalTotal
