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MoHMA Stethoscope, Stamp Bracelet 1.5" diaphragm of Bowle's type. The top has a screw protrusion and a metal bracelet screws i to the housing to allow attachment to the arm to hold it in place. The diaphragm is the type with a 0.5" button protruding to localized sound. Identical in ref 31 in bibliography, which calls it a bracelet chest piece. https://www.mohma.org/instruments/category/stethoscope/stethoscope_stamp_bracelet/