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ORDER FORM for ARTHROTRACE CAPSULES (90 Capsules per Tub)

Please send the following to:

NAME........................................................................ Tel. No: ..................

ADDRESS.................................................................................................

Town................................................. County............................................

Post Code.......................................... Date...............................................


ARTHROTRACE CAPSULES (90 Capsules per Tub)      
  Quantity Amount
1 to 3 Tubs at £12 each Tub + (P & P UK only: £2.00) ............... £..............
SPECIAL DISCOUNT OFFERS:
4 to 6 Tubs @ £11 each Tub + (P & P UK only: £2.50) ............... £..............
7 to 10 Tubs @ £10 each Tub + (P & P UK only: £4.00) ............... £..............
11 to 19 Tubs @ £10 each + (P & P UK only: £5.00) ............... £...............
20 or more Tubs @ £9 each (P & P UK only: £6.50) ............... £...............
    __________
  Total  
    ==========
Please make your cheque payable to Professor Ken S. Wright.

Send Cheque plus Form to:

Professor Ken S Wright
12 Clive Road
West Dulwich
London SE21 8BY