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	18809
Name	CT
Brand	CANON
Model	Asteion S4
Endorsement number	21100BZZ00359000
Status	Recommend Sold
Price
Comment	4 Slice CT
Specification & Options	YOM2011 TSX-021B Exp Count 258,582
Configuration	Gantry Patient Bed Console Phantom *Software
Condition	Patient ready
inquiry*	(1000characters)