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	17969
Name	CR System
Brand	FUJIFILM
Model	FCR CAPSULA 2
Endorsement number
Status	Sold
Price
Comment
Specification & Options	Dimension：590（W）×380（D）×810（H）mm Weight：99kg
Configuration	Capsura 2 Image Reader 4 Cassette 8x10, 10x12, 14x14, 14x17
Condition	Patient ready
inquiry*	(1000characters)