1UiUjijj LLWVIEi

LUmZ~1tJmfJtl1JfliW Lfl~amprti1afnlVimi hzUlYlPl1UJi4nmrNmi~mJlm Li4mhznmJtl1rIffiimVlaiiL~t1fi~1JfliM1fJLml8~~mi~tIL~ampnrIlil1nmi1JimurmlLil~nmitiiCltgtMJ

ntl~Y1t1LTi8fl11JJ1Jatltllia1t101i1iiCltiCltltl OiJJmi~t1a~Y11~Jn

~1t1i11 -ua2ola~itmiil~81JiJi8~LLY1a (~it01m~8~~LLaLi~JtI~Oian-ua2Ja) middotihVlLill UltJUllUllGl11

d I CII oCIio I 1GlrllUVIel~(VIGlllJl~rl~lIl~a 111)

L~lJtbjlvi1th~lfllfU DDDDD DDDDD DOD-U1V1L~1Uel-rmel ril -ulVlLilT~m~11nmdth~GltJjltJ

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tbGltJntJ~ Lnl1lll nrm1-U~rl1-UrlUU nalVIUL~afl11lJtJ~al1lntJ 1ums1-ff~tlHrlUU rnum~lJUriJVI1ltJn

Jga~Wn1~~LL VIU

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(mru~rlO1j12JGlllJl~tll~eurol-rmeuroll(lULeuroll1m oH~VlLLmUU~~lUlmLVIU) ~ ~~ ~

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1 fltJ QUeurol1qjl~LuU~ d~naU1lfllfYlL1llm~lJL~UVI

0 LLVIVIfl~1UeuroleurolTI5uamp1m1 uui1lnVl

1~(Ij111h~LijUUltJUllUllGl11 L~eurollU~ L~aU VIfl

1VltJijfl11lJ~nlj~llJia1 tJn

r---------- --~---------r----_ ---------------- -

tIiZUlYlfl111Jitmi

1 miLfl~a1J1on

WmjlJ1LL~1

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2 ~t1 (i~)

----shy - - --_bull bull - shy - shy - - - - - - - bull _---shy J

3 a1L11fl11JJit01i (LLY1ait~lflEJaLafJflL

410 LLlJULViEJ1J~~~Jl~fIIvn ft~1ilUV1d 42 0 LLUULViEJ1J1~ULVlijvfllvn ft~~ilUV1d

430 LLlJULViEJ1J1~u-nvlVl~ ft~~ilUV1d 44 0 lJ1LViEJ1J1~ul~Llh ~~ilUV1d

450 lJ1LViEJ1J~~U-nmli1 ft~~ilLLV1d 46 0 U1LViEJ1J1~ULVlijmi1 ft~~ilLL~d

470 U~ILViEJ1J1~uG11m a~~f)uV1d 48 0 1aVl~11JlJ1 ( ) tlij~gU ( ) tlij~EJ11 ft~~aLLV1d

O 1 0 1 u u 49 LIiIEJ-1UvUUUJG~11JmtlU~ 3 n ft~UaLLMVltJ 410 VlUvUa1Juv-1nUu~an~VlJ ft~Uf)UYIEJ

4110 LR~v-1~~L~1JVl ft~~aLLV1d 412 0 LR~v-1~~liItltln~LlU ft~~aLLV1dbull U1 u 0 II 1

413 O Ln1v-1U-1uv-1nULL~n~VnJ ft~UaLLV1EJ 414 1(l~11Jav ~EJn ~HUaLLytVIEJ

4150 1(lr-1iS111J~1 (ManuaL WheeLchair) ~v-11~-uv~alULLuulhLijUVlj1~ 3 h1R1u51U ft~~aLLV1d

( ) Standard () Independent ( ) Reclining

416 0 i(lr-31~vh (Power WheeLchair) ~tl-11Jliv1JalULLJJlhLijUVlj1~ 31l1R1u51U ft~~aLLVld bull I

j

nllltJ

( )

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J

1U~UJtJILLYiV1ejUjUmmm~ 6 L~tJUtJULLvilUyjllJ1llh~LiJU

LLUU~tJ1~m~~Un1J~UJtJII1n~~flwtJ~nJJ~n1JWl1Jru1nlilltJ1U~~~JJL~Ufi1tJ1JnJruli1EJLVl~tJ~~n1JBUL~tJI~111nn1J J

VIU123

410 LLlJULViEJ1J~~~Jl~fIIvn ft~1ilUV1d 42 0 LLUULViEJ1J1~ULVlijvfllvn ft~~ilUV1d

430 LLlJULViEJ1J1~u-nvlVl~ ft~~ilUV1d 44 0 lJ1LViEJ1J1~ul~Llh ~~ilUV1d

450 lJ1LViEJ1J~~U-nmli1 ft~~ilLLV1d 46 0 U1LViEJ1J1~ULVlijmi1 ft~~ilLL~d

470 U~ILViEJ1J1~uG11m a~~f)uV1d 48 0 1aVl~11JlJ1 ( ) tlij~gU ( ) tlij~EJ11 ft~~aLLV1d

O 1 0 1 u u 49 LIiIEJ-1UvUUUJG~11JmtlU~ 3 n ft~UaLLMVltJ 410 VlUvUa1Juv-1nUu~an~VlJ ft~Uf)UYIEJ

4110 LR~v-1~~L~1JVl ft~~aLLV1d 412 0 LR~v-1~~liItltln~LlU ft~~aLLV1dbull U1 u 0 II 1

413 O Ln1v-1U-1uv-1nULL~n~VnJ ft~UaLLV1EJ 414 1(l~11Jav ~EJn ~HUaLLytVIEJ

4150 1(lr-1iS111J~1 (ManuaL WheeLchair) ~v-11~-uv~alULLuulhLijUVlj1~ 3 h1R1u51U ft~~aLLV1d

( ) Standard () Independent ( ) Reclining

416 0 i(lr-31~vh (Power WheeLchair) ~tl-11Jliv1JalULLJJlhLijUVlj1~ 31l1R1u51U ft~~aLLVld bull I

j

nllltJ

( )

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(1) v1tJILhJLLfvlv11~~UV1auEJU1U1LJtJ~ru1lllh ntJU1ll1gWL1llnii~ (2) 1~LL~~H11LtJUflU~n1ierUL~tJI~111nn1ilh~UfiEJ~Ln~11nn1i1iJ1-ifUUl~1LLn~-UtJL~UmLU~l1mLYiV1V~lh~wU

J

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LLUU~tJ1~m~~Un1J~UJtJII1n~~flwtJ~nJJ~n1JWl1Jru1nlilltJ1U~~~JJL~Ufi1tJ1JnJruli1EJLVl~tJ~~n1JBUL~tJI~111nn1J J

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o LLUUtJSULeJUUeJUl~ (reclinin~) UUl~ dl 0 LLUUeUULfI~eJU~ltJl~yh (power wheelchair)

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0 ~ ~ _ 3 II 33 afllifU~~1LlJI-U()JmiddotU1JJ~Ul1i VlLmJ1~ftll~111J~fl1i1111J

(hh~J~u L-tlU LiJ~~11~LLlJul~ LtI~~~mfi11~ LVI~EJjLLnU~~m~lhl~lU-Uljl~ Wlin-nj~j~l lJ-ruLBUWlin~jl~ IUfl1UflJJ tgt~~luilfJll11 lJ-ruuu1~ LiJU~U)

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( -rJvhh~ diu)

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VlLh 33

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0 arnunfiUA1VO - 3 Jj

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2~1oSD ~r40C1Sl1lS10rne CTlJtJU

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bull doo~doourolm~lIYl1Sinuil Jffl~~ukoonel1lsiSfil5ouJYiou

nOOl~nsniUsnnlOOltiJilll1nlboolu6uJriou IoSD ~ rowXJroao)1IYl0011urJIooruuaocampilxnsi3sNOOwUlI8liiUlYl 5 n nsectofiJ1ds1Jro~iYYlI1ligtoo1OOun6Jliiu 3 iJ

_ bull 00- 14 _

[JaSUIJ1Uo~UOallSS n ~ I _~4_ __ $ GJ_

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0 arnunfiUA1VO - 3 Jj

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2~1oSD ~r40C1Sl1lS10rne CTlJtJU

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~ 4~lLLWlOO~

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bull doo~doourolm~lIYl1Sinuil Jffl~~ukoonel1lsiSfil5ouJYiou

nOOl~nsniUsnnlOOltiJilll1nlboolu6uJriou IoSD ~ rowXJroao)1IYl0011urJIooruuaocampilxnsi3sNOOwUlI8liiUlYl 5 n nsectofiJ1ds1Jro~iYYlI1ligtoo1OOun6Jliiu 3 iJ