83
CUSTOMER COPY
Mr./Mrs./Ms - - - --- --- -- --- --- -- --- -- --- --- -- --- -- --- --- -- --- -- ------ -- --- -- ----- --- -- -- --- --- --- -- --
Address - - -- --- ---- -- --- --- --- -- -- --- --- --- -- -- --- --- --- -- -- --- --- --- -- ----- --- -- -- --- --- --- -- --
Telephone No.: - - - --- ---- -- --- --- --- -- -- --- --- --- -- -- --- --- --- -- -- --- --- --- -- -- ---- --- -- -- --- --- --- -- --
Model Name: - - - --- ---- -- --- --- --- -- -- ------ --- -- -- --- --- --- -- -- --- --- --- -- -- ---- --- -- -- --- --- --- -- --
Serial No.: - - - -- ---- -- --- --- --- -- -- --- --- --- -- -- --- --- --- -- -- --- --- --- -- -- ----- --- -- -- --- --- --- -- --
Date of Purchase: - - - --- ---- -- --- --- --- -- -- --- --- --- -- -- --- --- --- -- -- --- --- --- -- -- ---- --- -- -- --- --- --- -- --
Cash Memo No. - - - --- ---- -- --- --- --- -- -- --- --- --- -- -- --- --- --- -- -- --- --- --- -- -- ---- --- -- -- --- --- --- -- --
Dealer Name & Address: - - - --- ---- -- --- --- --- -- -- --- --- --- -- -- --- --- --- -- -- ------ --- -- -- ---- --- -- -- --- --- --- -- --
- - - -- ---- -- --- --- --- -- -- --- --- --- -- -- --- --- --- -- -- --- --- --- -- -- ----- --- -- -- --- --- --- -- --
==============================================================
Service Station Copy
Mr./Mrs./Ms - - - --- --- -- --- --- -- --- -- --- --- -- --- -- --- --- -- --- -- ------ -- --- -- ----- --- -- -- --- --- --- -- --
Address - - -- --- ---- -- --- --- --- -- -- --- --- --- -- -- --- --- --- -- -- --- --- --- -- ----- --- -- -- --- --- --- -- --
Telephone No.: - - - --- ---- -- --- --- --- -- -- --- --- --- -- -- --- --- --- -- -- --- --- --- -- -- ---- --- -- -- --- --- --- -- --
Model Name: - - - --- ---- -- --- --- --- -- -- ------ --- -- -- --- --- --- -- -- --- --- --- -- -- ---- --- -- -- --- --- --- -- --
Serial No.: - - - -- ---- -- --- --- --- -- -- --- --- --- -- -- --- --- --- -- -- --- --- --- -- -- ----- --- -- -- --- --- --- -- --
Date of Purchase: - - - --- ---- -- --- --- --- -- -- --- --- --- -- -- --- --- --- -- -- --- --- --- -- -- ---- --- -- -- --- --- --- -- --
Cash Memo No. - - - --- ---- -- --- --- --- -- -- --- --- --- -- -- --- --- --- -- -- --- --- --- -- -- ---- --- -- -- --- --- --- -- --
Products Owned by the customer:
(Please tick in the appropriate box)
Washing Machine Refrigerator Color TV 100%ClothesDryer Dishwasher
Music System oven Toaster Grill
2 Wheeler
Car
Air Conditioner