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Distributor Application Form

Please fill in the details below to apply for authorised distributorship with Spictra.

Fields marked with * are mandatory.

Contact Person Details

Full Name *

Designation *

Mobile Number *

+91

Email Address *

Business & Market Details

Proposed Territory *

Existing Customer Network

Annual Sales Target (INR)

Warehouse Facility (if any)

Key Hospitals / Institutions (if any)

Why do you want to partner with Spictra? *

Product Interest

Select the product categories you are interested in distributing.

Membrane Oxygenators Arterial Bubble Traps Myocardial Protection Systems Cardioplegia Delivery Systems Perfusion Packs Hemoconcentrators Chest Drainage Systems Bedside Vacuum Controllers Other

Bank Details

Account Holder Name *

Bank Name *

Account Number *

IFSC Code *

Branch Name *

Account Type *

I declare that the above information is true and correct. *

Why Partner with Spictra?

Innovative Product Portfolio

Advanced perfusion and critical care solutions

Quality & Reliability

Manufactured to global standards

Attractive Commercial Terms

Competitive pricing and business support

Training & Technical Support

Product knowledge and application training

Dedicated Partner Support

A long-term and mutually beneficial relationship

Product Categories We Distribute

Membrane Oxygenators

Arterial Bubble Traps

Myocardial Protection Systems

Cardioplegia Delivery Systems

Perfusion Packs

Hemoconcentrators

Chest Drainage Systems

Bedside Vacuum Controllers

Upload Documents

Please upload the following documents (PDF, JPG or PNG, max 5 MB each).

Company Profile * Choose file PDF, JPG or PNG, max 5 MB

GST Registration Certificate * Choose file PDF, JPG or PNG, max 5 MB

PAN Card * Choose file PDF, JPG or PNG, max 5 MB

Director / Partner KYC (Aadhaar / Passport / PAN) * Choose file PDF, JPG or PNG, max 5 MB

Bank Account Proof (Cancelled Cheque / Bank Statement) * Choose file PDF, JPG or PNG, max 5 MB

Existing Customer List (if any) Choose file PDF, JPG or PNG, max 5 MB

Other Relevant Documents Choose file PDF, JPG or PNG, max 5 MB

An inspiring and innovation-driven medical technologies Company.

Contact Us

Medihub Sciencetec Private Limited
Plot No: 4, NH – 7, MMDA Industrial Estate
Maraimalai Nagar – 603 209, Tamilnadu, India.
+91 9500048346

+9144 4740 0478/4740 0484
enquiry@spictra.com

Products

Cardiac Surgery
Airway Management
Neurology
Transfusion

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