Title:Title:
Name:Name:
Residence Address:Residence Address:
Dist:Dist:
State: Occupation:State: Occupation:
Tel:(_____) Res(:_____) Fax:Tel:(_____) Res(:_____) Fax:
Mobile No: Email:Mobile No: Email:
Please Tick The Appropriate Product Colour TV B&W TV DVD Washing M/C. AC Plasma TV Rear Projection TVPlease Tick The Appropriate Product Colour TV B&W TV DVD Washing M/C. AC Plasma TV Rear Projection TV
Model No:Model No:
Serial NoSerial No
Purchase DatePurchase Date
Bill No.Bill No.
I Accept The Terms And Conditions of The Warranty Customer SignatureI Accept The Terms And Conditions of The Warranty Customer Signature
Thank you for selecting a World Class product and we assure you that it will perform as per your expectationsThank you for selecting a World Class product and we assure you that it will perform as per your expectations
We thank you for taking your time to complete this form. All Information Provided by You will be Kept Confidential.We thank you for taking your time to complete this form. All Information Provided by You will be Kept Confidential.
(Please Fill In, Tear off, Fold and Mail this form to Reach us within 10 days of the Product Purchase.)(Please Fill In, Tear off, Fold and Mail this form to Reach us within 10 days of the Product Purchase.)
We welcome your Valuable Suggestions, if any, to Improve our Products and Services :We welcome your Valuable Suggestions, if any, to Improve our Products and Services :
FOR OFFICE USE ONLYFOR OFFICE USE ONLY
Customer Code:Customer Code:
Customer DetailsCustomer Details
Product DetailsProduct Details
Serial No.Serial No.
Branch:Branch:
Note: Company Will Not Be Responsible For The Loss Of This Form During Transit.Note: Company Will Not Be Responsible For The Loss Of This Form During Transit.
Code CodeCode Code
Mr Ms Mrs M/sMr Ms Mrs M/s
Please Refer Sticker On Back Cover Of Your ProductPlease Refer Sticker On Back Cover Of Your Product
Day Month YearDay Month Year
Microwave Oven LCD TVMicrowave Oven LCD TV
MIRC Electronics LimitedMIRC Electronics Limited
Service Centre CopyService Centre Copy
Warranty CardWarranty Card
For Other Details on Our Products & Services Log On To www.onida.comFor Other Details on Our Products & Services Log On To www.onida.com
Dealer’s Name & AddressDealer’s Name & Address
Pin:Pin:
SignatureSignature
Mirc Electronics Ltd.Mirc Electronics Ltd.
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