Order Form Overview:
This document is an order form for inCoris Blocs, which are dental materials used in various dental procedures. The form is intended to be filled out and sent to a dealer via email or fax.

Customer Information Section:
The form requires the following customer details:

• Company Name
• Surname and First Name
• Street and House Number
• Postal Code and City
• Telephone and Fax Numbers
• Email Address
• Customer Number

Product Ordering Section:
The form lists various inCoris Blocs products available for order, categorized by type, size, and color. Each product entry includes:

• Product Name
• Size
• Color
• Quantity
• Reference Number (REF)

Product Variants:
The products are available in different sizes and colors, with specific reference numbers for each variant. The quantities per package vary, with some products available in packs of three and others as single pieces.

Special Notes:
Some products are marked with an asterisk (*) indicating they are only suitable for specific equipment (e.g., MC XL).