| Name of Company : * |
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| Name of Contact Person :* |
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| Address / City / Location : * |
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| Select Your Country |
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| Tel. No. / Cell No. : * |
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| Email : * |
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| QTY : |
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| Coupling Type : |
Single Shut Off
Double Shut Off
Through
Cam Lock
Special
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| Socket End Connection(With Size) : |
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| Plug End Connection : |
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| Type of Fluid Flowing Through Coupling : |
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| Pressure of fluid : |
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| Temperature of fluid : |
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| Seal (If possible) : |
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| Type of Lock : |
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| Any Special Requirement : |
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| Attach File |
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| Please, Enter Verification Code in the box: * |
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