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	18196
Name	Video Colonoscope
Brand	OLYMPUS
Model	PCF-H290ZI
Endorsement number	228ABBZX00014000
Status	Under Nego
Price
Comment	HDTV image quality and NBI mode. High Optical Magnification. Wide Viewing Angle RIT (Responsive Insertion Technology) *Waterproof One-touch Connector
Specification & Options	Insertion tube 11.8 mm Channel size 3.2mm *Working length 1330mm
Configuration
Condition	Patient ready
inquiry*	(1000characters)