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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 18547
Name X-ray
Brand SIMADZU
Model X’sy
Endorsement number
Status Sold
Price
Comment Floor to Ceiling tube stand.
Specification & Options
Configuration *Generator type: UD150L-40E *Tube Model: 0.6/1.2P38DE-85
Condition Patient ready
inquiry*
(1000characters)