home /  Request form

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 19065
Name Mobile X-ray
Brand HITACHI
Model Sirius Star Mobile
Endorsement number 21400BZZ00381000
Status Sold
Price
Comment Portable X-ray Sirius Star Mobile 130HP Series
Specification & Options
Configuration
Condition Patient ready
inquiry*
(1000characters)