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	21243
Name	Ultrasound Color Doppler
Brand	CANON
Model	SSA-700A Aplio50
Endorsement number
Status	New Arrival Sold
Price
Comment
Specification & Options	Color doppler, PW/CW doppler, TDI, PIMS image, DICOM kit, REF, CW Enhancement
Configuration	Convex PVT-375AT Linear PLT-704AT Sector PST-30BT
Condition	Patient ready
inquiry*	(1000characters)