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Request for a Proposal

please download and fill in the required questionnaire and send it back to us

Request for a Proposal

We appreciate your interests in contact us and welcoming your ideas anytime. We would like to follow-up with you to ensure the maximum knowledge of your opinion about our products and the business co-operation possibilities between us. Please take few minutes of your time to fill out the following information.


Personal Information

Name*

Work *

Title *

Address

City

Country*

Phone*

E-mail*

Web Site

Product Information

Product : millensys Dicom Viewer, MiViewer

Question

Type the displayed image : verification image, type it in the box