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	20798
Name	Video Gastroscope
Brand	FUJIFILM
Model	EG-3000N
Endorsement number
Status	New Arrival
Price
Comment	Work with 3200/3000/4450 series Processor
Specification & Options	Insertion tube 5.9mm Channel size 2.0mm Working length 1100mm
Configuration
Condition	-Patient ready
inquiry*	(1000characters)