Helpcard


Go to content

formularz dla dwóch osób

Order

Country:

Name

Surname


Personal ID number

phone number, the person to be informed:

blood type:

List of illnesses:

D - DIABETES
E - EPILEPSY
J - JAUNDICE
H - HIV VIRUS
HIP - HEARING-IMPAIRED PERSON
MP - MUTE PERSON
AH - ARTERIAL HYPERTENSION
DCV - DUAL CARDIAC VALVE
TCV - TRICUSPID CARDIAC VALVE
AV - Zastawka tętnicy głównej
AP - ARTIFICIAL PACEMAKER
LC - LUNG CANCER
AM - ALLERGY TO MEDICINES
A - ALLERGY TO OTHER ALLERGENS
SA - SUFFERED ACUTE CORONARY SYNDROMES
OTHER INFORMATION DEPENDING ON INDIVIDUAL REQUIREMENTS:

consent to donate body organs in case of death:
YES NO
Select:
Receipt
VAT invoice

Description

code

units

price (€)

Help Card

K-1

18,00

Emblem pinned

E-1

4,00

Stickers put on helmets

N-1

3,00

Square sticker

N-2

3,00

Rectangular sticker

N-3

3,00

Large emblem / coach /

E-2

15,00

Big sticker / boat /

N-4

10,00

Big sticker /aircrafts /

N-5

10,00

Big sticker /helikopter/

N-6

10,00

Big sticker /company/

N-7

10,00

TOTAL PRICE

 

Contact phone:
















address for delivery:








Home Page | Help Card | Stickers | Lamination | Order | Contact | Site Map


Back to content | Back to main menu