Order no.: ... Date Signature. Posterior seat height

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Start M6 Junior Scripted Order no.: Start M6 Junior Lightweight wheelchair Article number: 480F53=60000_K Provide estimate only Order Billing address/customer number Ottobock START_M6_647F263=EN-05-1510 Technical modifications and printing errors reserved Delivery address Sales person Seat measurements in cm Name... Date Signature Seat width (SW) 28 30.5 33 35.5 38 Seat depth (SD) 31 34 37 Seat height measurements in cm (table on the next page) Anterior seat height (ASH) 40 41 42 43 44 45 46 47 48 49 Standard equipment $1200 Aluminium tube frame with crossbrace Tip-assist integrated into the frame Individual footrests, angle-adjustable, plastic footplates Swing-away footrest holders Side panel with armrest, height-adjustable Nylon seat and back upholstery, black Modular design Rear wheels with quick-release axles Knee lever wheel lock Folding, max. user weight 90 kg/198 lbs Wheelchair dimensions Seat width (SW) cm Anterior seat height (ASH) cm Seat depth (SD) cm Posterior seat height (PSH) cm Back height (BH) cm Lower leg length (LL) (frame measurement) cm Posterior seat height 37 38 39 40 41 42 43 44 45 46 47 48 49 The number codes contained in this order form are not intended to be used as article numbers for spare parts orders. Please use the spare parts catalogue for spare parts orders. MASS 99/3/1 Start M6 Junior April 2016 1/6

Information Seat height table Anterior seat height in cm Caster fork, short Setting range Caster wheel diameter 5" 40 44 Caster wheel diameter 6" 43 45 Caster fork, long Caster wheel diameter 5" 44 47 Caster wheel diameter 6" 45 49 Seat height table Posterior seat height in cm Rear wheel size Setting range 20" 37 43 22" 38 45 24" 41 49 The values indicated are rounded values which have been theoretically determined. Max. deviation of 1 cm. The anterior seat height depends on the selected wheel size, caster fork and mounting position. Please refer to the seat height table! Specified without seat cushion at 0 seat inclination. The maximum possible seat inclination is 3.5 cm. MASS 99/3/1 Start M6 Junior April 20016 2/6

Frame accessories MA 55 Plug-on anti-tipper, right 34 MA 56 Plug-on anti-tipper, left 34 MA 57 Crutch holder, right 43 MA 58 Crutch holder, left 43 MA 61 Swinging anti-tipper, right 71 MA 62 Swinging anti-tipper, left 71 Caster wheels MF 03 5" solid rubber MF 05 6" pneumatic (150 x 30) MF 06 6" solid rubber (150 x 27) Caster forks MF 80 Caster fork, long MF 81 Caster fork, short Rear wheel size MG 04 20" MG 01 22" MG 02 24" Wheelbase short/active long/passive Rear wheel rim MG 05 Standard MG 80 Rear wheel with drum brake/attendant 440.00 Tyres MG 30 Pneumatic tyres 1 3/8" MG 35 PU tyres 1 3/8" Push rings MG 52 Push ring, aluminium, silver anodised, high MG 56 Push ring, polished stainless steel, high 47 Rear wheel accessories MG 87 High-pressure air pump, 14 bar 137 MG 88 Airman pump, battery-operated 203 Wheel lock MH 01 Knee lever wheel lock, standard MH 06 Knee lever wheel lock for user and attendant 286 Wheel lock accessories MH 10 Wheel lock lever extension 40 MASS 99/3/1 Start M6 Junior April 2016 3/6

Information MA 55 Plug-on anti-tipper MA 62 Swinging anti-tipper MD 10 Back angle adjustment 30 MD 11 Folding back MD 23 Thoracic support MD 54 Angled push handles ME 05 Side panel, height-adjustable MB 20 Footrest for short lower leg length MB 72 Heel strap MZ 53 Headrest MZ 54 Clinical installation set MZ 55 Multi-axis installation set MG 95 Spoke protector with decor MASS 99/3/1 Start M6 Junior April 20016 4/6

Back system MD 09 Back with lumbar curve, standard MD 01 Straight back, standard MD 10 Back angle adjustment 30 (only available with BH 37.5 cm) 273 MD 11 Back, folding (only available with BH 37.5 cm) 106 Back height in cm 30 32.5 35 37.5 Back upholstery MD 04 Standard MD 05 Adaptable 125 MD 06 Without Push handles MD 51 Standard MD 52 Telescoping (only available in combination with 30 back angle adjustment) 236 MD 54 Height-adjustable, angled 75 Back accessories MD 23 Side thoracic support, right 110 MD 24 Side thoracic support, left 110 MD 58 Back stabiliser for push handles 53 Side panels ME 01 Side panel, standard, 300 mm armrest, short mounted ME 01 Side panel, standard, 300 mm armrest, long mounted ME 05 Side panel, height-adjustable, 300 mm armrest 200 Side panel accessories ME 60 Tray 287 Seat upholstery MC 13 Upholstery, standard MC 06 Without Seat cushion MC 01 Seat cushion, standard 3 cm 5 cm 70 MC 02 Cubic Foam seat cushion (thickness 5 cm) 174 MC 05 Evolight seat cushion (thickness 6 cm) 419 Lower leg length in cm (without seat cushion) Lower leg length (LL) in cm... (available setting range 16 cm 45 cm) Footrest bar options MB 40 Short (27 40 cm) MB 41 Medium (32 45 cm) Please note that the lower leg lengths vary in case of elevating legrests. MASS 99/3/1 Start M6 Junior April 2016 5/6

Footrests MB 10 Individual footrests, angle-adjustable, plastic footplates MB 25 Legrest, elevating, without automatic length adjustment, pair 360 MB 26 MB 27 Legrest, elevating, without automatic length adjustment, right (plus standard footrest, left) Legrest, elevating, without automatic length adjustment, left (plus standard footrest, right) MB 20 Single-panel footrest for short lower leg length 200 MB 19 Individual footrests for short lower leg length 89 Footrest accessories MB 72 Heel strap for individual footrests 39 Other accessories MZ 50 Lap belt with plastic buckle 90 MZ 52 Tool kit 59 MZ 53 Headrest 138 MZ 54 Clinical installation kit for headrest 139 MZ 55 Headrest installation kit, multi-axis, offset 122 MZ 70 Anchor point kit for transportation in a motor vehicle (max. loading capacity: 60 kg) 406 Note: Please also use the order forms for wheelchair accessories 647F312 and 647F346. Spoke protector MG 90 Spoke protector, transparent 120 MG 95 Spoke protector with decor Add. charge Frame colour 009 Vinho sparkle (only with ME05 armrest) 017 Traffic yellow RAL 1023 018 Signal red RAL 3001 021 Sparkle granny-smith (only with ME05 armrest) 180 18 MASS 99/3/1 Start M6 Junior April 20016 6/6