Request

Request form

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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	19706
Name	Video Gastroscope
Brand	OLYMPUS
Model	GIF-XQ230
Endorsement number	06B0713
Status
Price
Comment	work with CV260/240/200 processor
Specification & Options	insertion tube 9.8mm channel size 2.8mm working length 1030mm
Configuration
Condition	Patient ready
inquiry*	(1000characters)