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	19109
Name	Endoscopy System
Brand	OLYMPUS
Model	CV-190 PLUS
Endorsement number
Status	Sold
Price
Comment	*EVIS EXERA III with GIF-H190N
Specification & Options	Processor 11kg Lightsource 18.2kg
Configuration	CV-190 Processor CLV-190 Lightsource GIF-H190N LCD monitor Key board Lightsource cable *Cords
Condition	Like New only for 54 patients used. Patient ready
inquiry*	(1000characters)