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	20010
Name	Colonoscope
Brand	OLYMPUS
Model	CF-HQ290ZI
Endorsement number	226ABBZX00094000
Status	New Arrival Recommend Sold
Price
Comment	HQ image
Specification & Options	Insertion tube 12.8mm Channel size 3.7mm Working length 1330mm
Configuration
Condition	Patient ready
inquiry*	(1000characters)