In corresponding, if the following questions are answered it will give us a very good idea of your condition and will better enable us to judge what will be suitable for you in the way of an artificial limb. Give the number as it appears before the question and then the answer to the question.
1. Your name
2. Post office
3. County
4. State
5. Age
6. Weight
7. Height
8. Occupation
9. Leg or arm amputated
10. When amputated
11. Right or left
12. Above or below elbow or knee
13. If above, give length from body
14. If below, give length from knee pan or elbow joint
15. What is condition of stump
16. Can you take any pressure on end of stump
17. Cause of amputation
18. Ever use an artificial limb
19. If so, what style and make, and how long
20. Was it satisfactory
21. If not, why
22. Have you one of our new catalogues
23. Would it be an inducement for you to give us an order if we sent a man to take your measurements
24. If we did so, would you stand a part of the expense
25. Do you wish to work for a free artificial limb premium? If so, we will send you particulars
Is there any special information you would
like on the subject of artificial limbs? If so, let us
know what it is, and we will do the best we can to
enlighten you.
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