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	18548
Name	CR System
Brand	FUJIFILM
Model	FCR CAPSULA
Endorsement number
Status	Sold
Price
Comment	Computed Radiography System
Specification & Options	DIM: W590 D380 H810㎝ Weight: 98Kg
Configuration	CR Workstation Image Reader *Cassette: 8x10 10x12 14x14
Condition	Patient ready
inquiry*	(1000characters)