Radiology OneSource

Phone: +1 615-577-1RAD(1723)
Fax: +1 615-577-1122
Email: Info@radiologyonesource.com

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I would like to purchase a system with the following specifications or...

I would like to sell a system with the following specifications.

Manufacturer:	_____________________	Model:	_____________________	Production Year:	____________
VIN:	_____________________	SiteID:	_____________________	Available Date:	____________

Mileage on Hub:

_____________________

CT MRI Cath/Angio Mammo Nuclear

Title State?	_____________________
Lien Holder	_____________________	Free and Clear

Trailer

Length:_____________________

Coach (Self Contained)

Trailor/Coach Shielded

Markings

Exterior	Describe:_____________________
Interior	Describe:_____________________

Condition

Exterior	Excellent	Very Good	Good	Fair	Poor
Interior	Excellent	Very Good	Good	Fair	Poor

On-board generator

Size:_____________________

A/C

System is under service contract

with:

_____________________

Equipment Location:

_____________________

System being replaced by:

_____________________

Notes:

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