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Industrial X-Ray Tubes Housing

Tubes must be prepaid with a completed Tube Service Report describing the reason for return, operating conditions, Installed and removal dates in order to recieve Warranty consideration.

* Required Fields
Salutation	Select Dr. Mr. Mrs. Ms. Miss.
* First Name
* Last Name
* Phone:
* Email:
* Date:	Ex. MM/DD/YYYY
	* Dealer       * OEM
* Dealer/OEM:
Address:
* City:
* State/Province:
Postal Code:
* Country:
* Institution: (Where Tube Installed)
Address:
* City:
* State:
Postal Code:
* Country:
Fax:

Return Tube Information * Insert Model: * Serial Number: Heat Exchanger Model: Serial Number: Generator Model: Serial Number:   * Principal Usage Cine Fluoro-Spot Film Special Procedure Remote Table General Radiography Tomographic Pulsed Fluoro           X-ray Tube Operation or Heat Exchanger (if returned separately): Anode Rotation Speed * Date Removed: Ex. MM/DD/YYYY Exposure Count: * Date Installed: Ex. MM/DD/YYYY Exposure Count:     Total Exposures: Estimated Exposures @ 60Hz   Estimated Exposures @ 180Hz     Techniques at Time of Difficulty * kV * mA * Time Techniques Most Frequently Used * kV * mA * Time Radiographic Technique Max kV used: Max mA used:   * Describe in detail the circumstances and reasons for the removal and return: Replacement Tube * Insert Model: * Serial Number: Additional Comments:

    

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