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	17945
Name	CT
Brand	GE
Model	ProSpeed II
Endorsement number
Status	Sold
Price
Comment	Dual Slice CT Scanner.
Specification & Options	YOM2010 Tube Type: MX135 Current tube mAs: mAs
Configuration	Gantry Patient Couch Console Phantom *Software
Condition	Patient ready
inquiry*	(1000characters)