| ForeStar International Inc. Order Form For Patients | 1/6/08 |
| Order by(Credit Card Holder): | | SHIP TO: |
| Credit Card 's Billing Address: | | |
| | | |
| TEL: | | TEL: |
| Product Names | Size | Product Functions and Indications | Unit | Qty. | Total |
| 產品名稱 | 包裝規格 | 產品功能及適用病症 | Price | | 總計 |
| HuaLiuWan | 380 g / btl | Form thick membranes around tumors, prevent tumors | $198 | | $ |
| (Tumor Shrink & Vanish) | (1 month supply) | absorbing blood and oxygen from connective tissues. | | | |
| | | Shrink & Vanish Tumors w/o surgery, cure or extend life. | | | |
| | | (對各種良性﹑惡性腫瘤瘤體週圍封固,使其斷血斷氧,治愈 | | | |
| 化瘤丸 | 380克 / 瓶(一月) | 或得到控製延長生命) | | | |
| Acupressure Footpatch | 30 pchs/box | Support healthy glucose, promote blood | $25 | | $ |
| for Diabetes | (2 wks supply) | circulation, relieve diabetes symptoms. | | | |
| 糖尿足貼 | 30貼/盒 | (促進血液循環﹐緩解﹑消除由糖尿病引起的併發症﹐降低血糖) | | | |
| Hypertension Patch | 30 pchs/bag | Promote healthy blood pressure | $28 | | $ |
| | (1 month supply) | supply sufficient blood to brain | | | |
| 降壓貼 | 30貼/袋 | (迅速降血壓至正常﹐使大腦供血充足﹐頭腦清醒) | | | |
| Prostate Patch | 30 pchs/bag | Improve prostate enlargement, | $26 | | $ |
| | (1 month supply) | reduce frequent urination etc. | | | |
| | | (消除前列腺肥大以及對前列腺肥大引起的諸症尿路不暢﹑尿頻﹑尿急﹑尿不淨﹑尿淋瀝不止﹑尿失禁夜間起夜如廁小便頻繁等症狀有改善及治療作用) | | | |
| 前列通貼 | 30貼/袋 | | | |
| Women Easy Flow Patch | 30 pchs/bag | Promote women bladder control, | $26 | | $ |
| | (2 wks supply) | reduce frequent urination etc. | | | |
| 坤順通貼 | 30貼/袋 | (改善及治療女性尿路不暢﹑尿頻﹑尿急﹑尿不淨﹑尿淋瀝不止﹑尿失禁夜間尿頻) | | | |
| Severe Pain Patch | 10 pchs/bag | Severe pain relief especially for | $10 | | $ |
| | | Cervical Vertebra pain & Cancer pain | | | |
| 劇痛貼 | 10貼/袋 | (劇痛止痛尤其對頸椎疼痛﹑癌症疼痛) | | | |
| HPV Wart OVER spray | 6ml / bottle | 100% Cure HPV genital wart for men and women | $69.99 | | $ |
| (尖銳濕疣)去跟 | 6毫升/瓶 | (100% 治癒男性﹑女性尖銳濕疣) | | | |
| Desert Oasis | 8 fl oz / btl | Stop hair loss and Regrow hair in 3 to 12 months | $20 | | $ |
| Fast Hair ReGrowth Spray | (2-4 wks use) | (通經化瘀﹐溝通頭皮與腦內之血脈﹐ | | | |
| 戈壁春快速生發液 | 8盎司/瓶 | 快速生發﹐專治脂溢性脫髮﹐斑禿) | | | |
| Anti-Wrinkle & Radiant Skin | 10 g / bag | Remove deep and fine wrinkle | $20 | | $ |
| | (2 wks 兩周量) | and have radiant skin in less than 2 weeks | | | |
| 駐顏粉 | 10克/袋 | (兩周內袪皺亮膚) | | | |
| EyeSight Guard | 4 fl oz / bottle | EyeSight recovery and eye fatigue relief | $8 | | $ |
| (Eye Lid Rub Solution) | (keep in Fridge) | (best for students, elderly & people working in office) | | | |
| 視力保眼藥水 | (冰箱保存) | (恢復視力﹐消除眼睛疲勞﹐適合學生﹑辦公室人員及老年人使用) | | | |
| Visa MasterCard American Express Discover | | | TX Residents Add 8.25% Sales Tax:$ | |
| Credit Card No: | | | | **Shipping & Handling:$ | 7.00 |
| Expiration Date: | | | | C.O.D.(Money Order only):$ | 7.50 |
| 3 digit code on back of Card: | | | | GRAND TOTAL:$ | |
| Print Name as on Credit Card: | | | | |
| Signature as on Credit Card: | | | ** Free on Orders of $150 or more |
| X | | Exceptions: Alaska and Hawaii |
| If paying by check, your DL# & Home Tel: | | | | | | |
| Please make check payable to: ForeStar Int'l Inc., 5206 Meadow Landing Ln, Sugar Land, TX 77479, U.S.A |
| 電話Phone: 832-858-8666 www.naturalhealingpatch.com Email: ForeStarUSA@yahoo.com |