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Fax:
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Company / Facility: *
Equipment Model: *
Year: *	Manufacturer: * Select General Electric Siemens Picker/Marconi Hitachi Toshiba Philips Shimadzu Other
Hertz:	50Hz      60Hz
Magnet Shielding Type:	Select Passive Active
Magnet Type:	Select Permanent / Open Super Conducting / Short Bore Super Conducting / Long Bore Super Conducting / Open Resistive Electro
Computer:
Coils:
Gradient mT/m:
Consoles:	Operator Diagnostic Independent Workstation Other
Imager:	Select 3M 831 3M 952 3M 959 Kodak 1120 Kodak 2180 Kodak Dryview 8100 Kodak Dryview 8700 Other
Storage Device:	Select Magnetic Tape Optical Disk
Software:	Fast Spin Echo MRA Advanced MRA Phased Array
Software Revision, Other Features, Other Hardware:
Who has been servicing the system?
Availability Date:
Installed        Deinstalled
Location: (City/State/Country)
Please enter your Country: Select Country / Region USA UK Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antigua Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Barbuda Belgium Belize Benin Bermuda Bhutan Bolivia Bonaire Botswana Brazil British Virgin isl. Brunei Bulgaria Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Rep. Chad Channel Islands Chile China Colombia Congo Cook Islands Costa Rica Croatia Curacao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Faeroe Islands Fiji Finland France French Guiana French Polynesia Gabon Gambia Georgia Germany Ghana Gibraltar Great Britain Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Irak Iran Ireland Ireland, Northern Israel Italy Ivory Coast Jamaica Japan Jordan Kazakhstan Kenya Kuwait Kyrgyzstan Latvia Lebanon Liberia Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mexico Micronesia Moldova Monaco Mongolia Montserrat Morocco Mozambique Myanmar/Burma Namibia Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Poland Portugal Puerto Rico Qatar Reunion Rwanda Saba Saipan Saudi Arabia Scotland Senegal Seychelles Sierra Leone Singapore Slovak Republic Slovenia South Africa South Korea Spain Sri Lanka Sudan Suriname Swaziland Sweden Switzerland Syria Taiwan Tanzania Thailand Togo Trinidad-Tobago Tunisia Turkey Turkmenistan United Arab Emirates U.S. Virgin Islands U.S.A. Uganda United Kingdom Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam Wales Yemen Yugoslavia Zaire Zambia Zimbabwe
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Where is the system?	Select Hospital Clinic Warehouse CIF Other
Notes:
Includes:	Manuals Phantoms Cabling Base Plate
Quote for:	Market Valuation       Sale