Request

Request form

Complete this form.

Company Name*
Your Name*
E-mail Address*
E-mail Address(Retype)*
Zip Code	( ex：999-9999 )
Country
Address1*
Address2
Telephone*	( ex：03-9999-9999 )
Fax	( ex：03-9999-9999 )
Mobile phone
Code	16848
Name	Video Gastroscope
Brand	OLYMPUS
Model	GIF-HQ290
Endorsement number
Status	Recommend
Price
Comment	HD Gastroscope Work with CV-290 Processor
Specification & Options	Insertion Tube 9.9mm Channel Size 2.8mm *Working Length 1,030mm
Configuration
Condition	Parts scope
inquiry*	(1000characters)