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Notes
WARRANTY CARD
Upon submission in this card we will extend the warranty on your ERGOLINE
®
to cover
a total of 2 years Please fill out this warranty card carefully and completely and return
it to us Thank you very much
Payer/Health Insurance Fund:
Location of the payer:
Serial number:
Delivery date:
Name of the patient:
Street:
Postal code/Place:
Telephone*:
Email*:
*Optional
Summary of Contents for Ergoline Aktiv
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