To:

Cochlear India Representative/Distributor

Cochlear India Head office
Level 9
Maker Chambers V
Nariman Point
Mumbai - 400021
Toll Free : 1800 2095 095

Freedom Accessory Order Form India - INR

Clinic/Hospital/Customer Name
Contact Person

Phone Number

Invoice To (Name)
Address

Part No

Description

Date:

Size

Unit Price
INR

Qty

Purchase Order #

Ship To
Address

Total

Part No

Description

Music, Sound & Listening Accessories

Size

Unit Price
INR

Z60831
TV/Hi-Fi Adaptor Cable

10990

Z60829
Personal Audio Cable
Z60830

7690

4030

Dry & Store

Z60761 Asia Pacific

7790

1260

FM Cables
Z77089
FM2-E
Z77090
FM10-E

60cm
60cm

3160
3160

Dry & Store Dry-Brik Desiccant

Z60764 Desiccant (minimum order 6)
Metal Can Dessicant
Z61088
Everyday Case
Y61471

Z77092
Z77093
Z77094
Z77095
Z77098
Z60369
Z60370
Z60372
Z60373
Z60374

60cm
60cm
60cm
60cm
60cm
90cm
90cm
90cm
90cm
90cm

3160
3160
3160
3160
3160
3160
3160
3160
3160
3160

Drying Capsules
N94527 4 pack
430
Freedom Battery Holder Keyring
Z60876
350
Storage & Accessories Case
Z60821
2640
Everyday Components
Freedom Bodyworn Cable Clip
Z61124 3 per pack
530
Freedom Earhook Set

Z60375
FM15-E
90cm
Z60377
FM18-E
90cm
Freedom Bodyworn Cable (FM)

3160
3160

S50742
S50743
S50744
S50798

8070
8070
8070
8070

Silver
Silver
Silver
Silver

30cm
50cm
80cm
100cm

N34403F Issue 1

Total

Care & Maintenance Accessories

Lapel Microphone

FM12-E
FM13-E
FM14-E
FM15-E
FM18-E
FM2-E
FM10-E
FM12-E
FM13-E
FM14-E

Qty

880

Z60700
1120

Freedom Enhanced Earhook

Z61091 6 (3 small & 3 large)
1120

Z61092 20 large
2800

Z61093 20 small
2800

Freedom Microphone Protector Set (mixed colours) 4 pack

Z60840 Pearl
2000

Z60841 Matt
2000

Freedom Microphone Protector Set (replacement) 4 pack

Z60696 Beige
2000

Z60697 Brown
2000

Z60698 Black
2000

Z60699 Silver
2000

Z60834 Pink
2000

Z60833 Blue
2000

Prices Effective 01 May 2010

700

Page 1 of 5

Part No

Description

Size

Unit price
INR

Qty

Total

Freedom Microphone Lock

Part No

Description

Size

Unit Price
INR

Qty

Total

Freedom Mini BTE Battery Holders

Z60922

1470

Freedom Mini BTE Back Panels (coloured)

Z61030

Beige

2800

Z61031

Brown

2800

Z60972

Beige

430

Z61032

Black

2800

Z60973

Brown

430

Z61033

Silver

2800

Z60974

Black

430

Z61034

Pink

2800

Z60975

Silver

430

Z61035

Blue

2800

Z60977

Pink

430

Z60976

Blue

430

860

Mini BTE Colour Panels

Z61013

Mixed Colours (x12)

Power & Battery Accessories

Sport & Lifestyle Accessories

Freedom Bodyworn Controller Pouch
Z61117

White Leather

1740

Z61118

Grey Leather

1740

Z61119

Black Leather

1740

530
530

270

Power Base Battery Charger C5105

Z60772

Freedom Bodyworn Harness

450

Z60826
Z60827

Powerone Implant Plus P675 batteries (6 pack)

Small
Medium

B13033

Card

Each

B13033

Box

10 cards

4500

Freedom Bodyworn Armband

B13033

Carton

5 boxes

22500

Z60828

Freedom Behind The Ear (BTE) Rechargeable Battery System

Z60842

Red

1780

(Includes-)

Z60843

Blue

1780

Please select 2 coloured batteries per system

Z60844

Black

1780

Z60845

Purple

1780

Pink

1780

BTE Rechargeable Battery System

33410

Black

Freedom Bodyworn Sports Armband

Z61020

Beige BTE Battery

Z61021

Brown BTE Battery

Z60846

Z61022

Black BTE Battery

Freedom Bodyworn Sports Waistband

Z61023

Silver BTE Battery

Z60852

Red

Small

1830

Z61025

Pink BTE Battery

Z60853

Blue

Small

1830

Z61024

Blue BTE Battery

Z60854

Black

Small

1830

Z60839

Recharger

11380

Z60855

Purple

Small

1830

Z60838

Power Supply

1370

Z60856

Pink

Small

1830

Z60961

International Plug Pack

Z60857

Red

Medium

1830

Z60837

12v Car Adaptor

Z60858

Blue

Medium

1830

Z60859

Black

Medium

1830

BTE Rechargeable Batteries *individual batteries only, requires charger

Z61020

Beige BTE Battery

10680

Z60860

Purple

Medium

1830

Z61021

Brown BTE Battery

10680

Z60861

Pink

Medium

1830

Z61022

Black BTE Battery

10680

Z60862

Red

Large

1830

Z61023

Silver BTE Battery

10680

Z60863

Blue

Large

1830

Z61025

Pink BTE Battery

10680

Z60864

Black

Large

1830

Z61024

Blue BTE Battery

10680

Z60865

Purple

Large

1830

Z60866

Pink

Large

1830

Freedom BTE Battery Holder

Z60775

Beige

3470

Sonic Boom Vibrating Alarm Clock

Z60776

Brown

3470

Z61094

Z60777
Z60778

Black
Silver

3470
3470

Eneloop Rechargeable Battery

B13026
AA

450

Z60825

Pink

3470

Z60824

Blue

3470

B13022?

250

N34403F Issue 1

Prices Effective 01 May 2010

AAA

Page 2 of 5

Part No

Description

Size

Unit Price
INR

Qty

Total

Paediatric Accessories

Description

Size

Unit Price
INR

Qty

Total

Freedom Bodyworn Controller

Freedom Babyworn Accessories Pack

Z126961

Part No

S50612
1050

48060

Freedom Bodyworn Controller Cable

S50709

Beige

30cm

8070

Z126954

Beige

8070

S50710

Brown

30cm

8070

Z126956

Brown

8070

S50711

Black

30cm

8070

Z126955

Black

8070

S50712

Silver

30cm

8070

Z126957

Silver

8070

S50771

Pink

30cm

8070

Z126958

Pink

8070

S50772

Blue

30cm

8070

Z126959

Blue

8070

S50713

Beige

50cm

8070

S50714

Brown

50cm

8070

Freedom Babyworn Cable

Freedom Snugfit
Z61207

Beige Small

2100

S50715

Black

50cm

8070

Z61208

Brown Small

2100

S50716

Silver

50cm

8070

Z60971

Black Small

2100

S50773

Pink

50cm

8070

Z179839

Beige Large

2100

S50774

Blue

50cm

8070

Z179838

Brown Large

2100

S50717

Beige

80cm

8070

Z179834

Black Large

2100

S50718

Brown

80cm

8070

S50719

Black

80cm

8070

Z60800

Beige

2990

S50720

Silver

80cm

8070

Z60786

Brown

2990

S50775

Pink

80cm

8070

Z60787

Black

2990

S50776

Blue

80cm

8070

Z60788

Silver

2990

S50792

Beige

100cm

8070

Z61218

Pink

2990

S50793

Brown

100cm

8070

Z61219

Blue

2990

S50794

Black

100cm

8070

S50795

Silver

100cm

8070

Freedom Tamper-Resistant Battery Holder & Tool

Freedom Tamper-Resistant Mini Battery Holder & Tool

Z60714

Beige

2990

S50796

Pink

100cm

8070

Z60965

Brown

2990

S50797

Blue

100cm

8070

Z60716

Black

2990

60886

Silver

2990

Z60771

Pink

2990

Z60885

Blue

2990

Freedom Tamper-Resistant Holder Extraction Tool (only)

Z60388

1050

4350

Freedom Monitor Earphones

Z60832
Signal Check
Z22502

Nucleus Freedom Speech Processor Spares

Freedom Behind the Ear (BTE) Controller

Freedom Coil
Z61008

Beige

6cm

8250

Z61009

Brown

6cm

8250

Z61010

Black

6cm

8250

Z61011

Silver

6cm

8250

Z60655
Z60656

Beige
Brown

8cm
8cm

8250
8250

Z60657

Black

8cm

8250

Z60658

Silver

8cm

8250

Z60659

Beige

11cm

8250

Z60660

Brown

11cm

8250

Z60661

Black

11cm

8250

Z60662

Silver

11cm

8250

S50610

Beige

48060

Z60663

Beige

28cm

8250

S50624

Brown

48060

Z60664

Brown

28cm

8250

S50625

Black

48060

Z60665

Black

28cm

8250

S50626

Silver

48060

Z60666

Silver

28cm

8250

S50780

Pink

48060

S50781

Blue

48060

N34403F Issue 1

Prices Effective 01 May 2010

Page 3 of 5

Part No

Description

N34403F Issue 1

Size

Unit Price
INR

Qty

Total

Part No

Prices Effective 01 May 2010

Description

Size

Unit Price
INR

Qty

Total

Page 4 of 5

Coil Magnet

Freedom Mini Behind The Ear (BTE) Controller (Two Zinc Air)
Silver Mini BTE

Z43129

Beige

1930

Z29719

Beige

1930

S50856

Silver BTE Controller

Z29720

Beige

1930

Z61033

Silver BTE Holder

Z29721

Beige

1930

Z60975

Silver Cover Back Panel

Z29312

Beige

1930

Pink Mini BTE

Z60311

Beige

1930

(includes)

Z61148

Beige

1930

S50858

Pink BTE Controller

Z43125

Brown

1930

Z61034

Pink BTE Holder

Z29722

Brown

1930

Z60977

Pink Cover Back Panel

Z29723

Brown

1930

Blue Mini BTE

Z29724

Brown

1930

(includes)

Z29313

Brown

1930

S50857

Blue BTE Controller

Z60312

Brown

1930

Z61035

Blue BTE Holder

Z61149

Brown

1930

Z60976

Blue Cover Back Panel

Z43136

Black

1930

Black Mini BTE

Z29725

Black

1930

(includes)

Z29726

Black

1930

S50855

Black BTE Controller

Z29727

Black

1930

Z61032

Black BTE Holder

Z29314

Black

1930

Z60974

Black Cover Back Panel

Z60313

Black

1930

Brown Mini BTE

Z61150

Black

1930

(includes)

Z60416

Silver

1930

S50854

Brown BTE Controller

Z60417

Silver

1930

Z61031

Brown BTE Holder

Z60418

Silver

1930

Z60973

Brown Cover Back Panel

Z60419

Silver

1930

Beige Mini BTE

Z60420

Silver

1930

(Includes)

Z60421

Silver

1930

S50853

Beige BTE Controller

Z61151

Silver

1930

Z61030

Beige BTE Holder

Z60972

Beige Cover Back Panel

15820

(includes)

15820

15820

15820

15820

15820

N34403F Issue 1

Prices Effective 01 May 2010

Page 5 of 5