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E-Warranty
Formulir online pengajuan klaim garansi.
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* Indicates required question
Nama Anda
*
Your answer
Tanggal Klaim Produk
*
MM
/
DD
/
YYYY
No. Whatsapp
*
Your answer
Perusahaan Tempat Anda Bekerja
Your answer
Nama RS / Proyek
Your answer
Distributor Tempat Anda Membeli
*
Your answer
Jenis Produk
*
Alarm Gas Medis Konvensional
Alarm Gas Medis Digital
Alarm Gas Medis IoT
Alarm Gas Medis OnBoard
Shut OFF Zone Valve
Gas Outlet CIG Screw ISO
Gas Outlet Quick Connect JIS
Bedhead Wallduct Oval-Oval
Bedhead Wallduct Oval-Prisma
Medical Gas Compressed Air System
Medical Gas Vacuum Suction System
Medical Gas Automatic Changeover Manifold
Tanggal Pemasangan
MM
/
DD
/
YYYY
No. Seri produk / Kode Produksi
Your answer
Uraian Lengkap Keluhan / Masalah / Kerusakan / Efek Samping (Jelaskan Sedetail Mungkin)
*
Your answer
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