Product Order Form
Please print out and complete the following form. Orders should be mailed along with a check made payable to 'AGH' to the following address:
Allegheny General Hospital
Attention: Bloodless Medicine
320 East North Avenue
Pittsburgh, PA 15212
Product |
Qty |
Price |
Subtotal |
Medical Alert Keychains |
$5.00 |
||
Magnetic Wipe Off Memo BoardLimited Time Offer - 2 for $5! |
2/$5.00 |
||
AGH Padfolio |
$20.00 |
||
Additional Donation |
|||
Add $5.00 shipping for each AGH Padfolio |
$5.00 |
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Total: |