サンプル請求

The free product sample of the physics and chemistry equipment sales 'Osaka Chemical' can be requested here.
Please transmit after inputting the wanted product by the following sample request form or Fax.

Request by Fax

Please print out and use this page after putting check in either "Autosampler vial" or "other product" in the top of following form.

Fax:06-6311-1070

Request sample form

At first, please put the check in either "Autosampler vial" or "All Plastic Syringe"or "other product".And then, please input necessary items, and click [confirm] button.
You move to the confirmation screen of content. When the mistake is not found, click the button,and it becomes "request completion".We contact to you as soon as we can confirm it, and we have you send the material to crush.

The item marked * is an input required item.

SSL グローバルサインのサイトシール

This site introduces SSL of the GeoTrust (electronic certification system).
All information sent from the customer is encrypted, so inquire at ease, please.



 

First name*
Last name*
Company*
Part section
Company address* ex.)530-0045


ex.) 5-17 Acty Minamimorimachi 2F,tenjin-nishimachi,Kita-ku,Osaka
Phone* ex.) 06-6311-1050
Fax ex.) 06-6311-1070
E-Mail* ex.) info@daichem.co.jp

Please input it if you have the company purchased that hopes.

Company purchased
Person in charge
Phone
Fax

Please input the End user name in the case of the application of the dealer.
Please input the information of the yourself in the case of the end user.

End user
Part section
Company address ex.)530-0045


ex.) 5-17 Acty Minamimorimachi 2F,tenjin-nishimachi,Kita-ku,Osaka
Person in charge
Phone
Fax

Please input machine parts name and the manufacturer that you use now.

(1)
Machine parts name
Manufacturer
Using vial Genuine Other
(2) Machine parts name
Manufacturer
Using vial Genuine Other
(3) Machine parts name
Manufacturer
Using vial Genuine Other

Hope sumple(up to three per one item) Product list

Product NO. Product name Hope number

Please inquire when you don't find the wanted product in the Product list.

Other message

First name*
Last name*
Company*
Part section
Company address* ex.)530-0045


ex.) 5-17 Acty Minamimorimachi 2F,tenjin-nishimachi,Kita-ku,Osaka
Phone* ex.) 06-6311-1050
Fax ex.) 06-6311-1070
E-Mail* ex.) info@daichem.co.jp
Hoped reporting method* Phone Fax E-Mail

Please input it if you have the company purchased that hopes.

Company purchased
Person in charge
Phone
Fax

Please input the End user name in the case of the application of the dealer.
Please input the information of the yourself in the case of the end user.

End user
Part section
Company address ex.)530-0045


ex.) 5-17 Acty Minamimorimachi 2F,tenjin-nishimachi,Kita-ku,Osaka
Person in charge
Phone
Fax

Hope sumple(up to three per one item)

Product NO. Product name Hope number

Please inquire when you don't find the wanted product in the Product list.

Other message

First name*
Last name*
Company*
Part section
Company address* ex.)530-0045


ex.) 5-17 Acty Minamimorimachi 2F,tenjin-nishimachi,Kita-ku,Osaka
Phone* ex.) 06-6311-1050
Fax ex.) 06-6311-1070
E-Mail* ex.) info@daichem.co.jp
Hoped reporting method* Phone Fax E-Mail

Please input it if you have the company purchased that hopes.

Company purchased
Person in charge
Phone
Fax

Please input the End user name in the case of the application of the dealer.
Please input the information of the yourself in the case of the end user.

End user
Part section
Company address ex.)530-0045


ex.) 5-17 Acty Minamimorimachi 2F,tenjin-nishimachi,Kita-ku,Osaka
Person in charge
Phone
Fax

Hope sumple(※All plastic syringe is for each one)

Product NO. Product name Hope number
pcs
pcs
pcs
pcs
pcs

Please inquire when you don't find the wanted product in the Product list.

Purpose for use*

Other message

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OSAKA CHEMICAL Co.,Ltd.5-17 Acty Minamimorimachi 2F,tenjin-nishimachi,Kita-ku,Osaka 530-0045,Japan
Tel:+81 06-6311-1050  Fax:+81 06-6311-1070
E-mail:info@daichem.co.jp URL:http://www.daichem.co.jp/

Copylight(C) 2007. OSAKA CHEMICAL CO.LTD. All Rights Reserved.