Esco Medical | IVF Workstations, Time Lapse Incubator, CO2 Incubators

* Name

* Title

* Company

* Email

* Mobile Number

*End User (Name of Institute)

* Country

* Delivery Address

(Pls. indicate the complete delivery address for the replacement part including the 'Attention to' detail)

* Attention to

* Courier Account No

(The limited warranty covers parts only and not transportation / insurance charges)

* Product Category

* Product name

* Serial/LOT Number

* Date of the installation

* Problem Discovered

* Nature of Problem

If Others, specify

* Type of Problem

If Others, specify

Injury of patient or user

Yes

* Description of complaint / Feedback

Immediate action taken / corrections (if any)

(*) Required

Submit a Defect Form