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Date
2011
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*
Company name
*
Adress
*
Contact person
*
Phone
*
E-mail
*
Type of service
choose
serwis gwarancyjny
serwis pogwarancyjny
inna usługa serwisowa
Brand
choose
asian plastic
fanuc
femco
fpt
hartford
honor seiki
mega machine
mori seiki
poly gim
proth
quaser
seyi
supertec
kent
sure first
Machine model (np. NL2500)
Machnine serial number
Type of failure
choose
mechanical
electric
controller
other
Details of failure
Error code
Alarm message
* - required field
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