Request Form

Name and address of the Customer :
Institution / Department :
Phone :
Email :
Name of Equipment :	Gel Documentation Systems
Application:	Florescence / Absorption Chemiluminescence Both
Train_Illuminator:	20cm x 20cm 20cm x 30cm 20cm x 20cm dual wavelength 20cm x 30cm dual wavelength
Type of Camera :	CCD 8-bit CCD 16-bit CCD 8-bit high resolution CCD 16-bit high resolution Digital 4 million pixels Digital 5 million pixels
Printer :	Digital Thermal Printer Laser printer Photo Quality Inkjet Printer Inkjet Printer
Computer :	Branded (hp, Compaq, IBM etc.) Branded Imported Indian Assembled
I want a stand alone Gel Documentation System which can be used without a computer and can easily be attached to any printer."