
Name Male/Female Date of Birth
Address
City Country Postal Code
Phone Number
Healthcare Professional Who Recommended City Country
Store/Pharmacy Name Where Purchased City Country
Date of Purchase Model No: Serial/Lot No.
77
76
Emergency Card
Warranty Card
*Please fill this card and carry with you at anytime.
EMERGENCY CARD
Blood Glucose Monitoring System
I am a diabetes patient. If you
find me in a coma or stupor,
please take me to the
hospital on left side. Or call :
• User Name:
•
• Blood Type:
• Doctor/Hospital:
User Phone No.:
Thank you for answering these questions and for your purchase of the Blood Glucose Monitoring System.
®
Rightest
Do you have Type I Type II Gestational Diabetes ?
Have you owned a blood glucose monitor before ? Yes No
Which brand/s were you most recently using ?
Will the meter be your primary monitor ? Yes No
How often do you test your blood glucose ? Times per day per week
Do you use insulin ? Yes No Oral medication ? Yes No
How did you hear about the Blood Glucose meter ?
®
Rightest
®
Rightest
Thank you for purchasing our product. Please complete and mail this warranty card within 30 days of purchase of your Blood Glucose
Monitoring System.
®
Rightest
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