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	19371
Name	Video Colonoscope
Brand	OLYMPUS
Model	PCF-Q240ZI
Endorsement number
Status	Sold
Price
Comment
Specification & Options	insertion tube11.5mm channel size 3.2mm working length 1330mm work with CV260/240 processor
Configuration
Condition
inquiry*	(1000characters)