Customer's address: ..............................................................................
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Telephone: ..............................................................................................
Telex: .......................................................................................................
Fax: .........................................................................................................
Type of unit or part: .................................................................................
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Serial number : .
Short description of defective unit or part: ...............................................
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Do you want a quotation before repair is started:..........yes / no.............
Repaired unit has to be returned to the following address:
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50447/SGTN/1306
Service Request
SN
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6
HERMetic Sampler GTN Chem