g]kfn 6]lnsd

k|of]ustf{sf]
kf;kf]6{
;fO{hsf] kmf]6f]

-g]kfn b"/;~rf/
;~rf/ sDkgL lnld6]8_

df]afO{n ;]jf lgb]{zgfno

sfof{no k|of]hgsf] nflu

btf{ g+=
ldlt
!= u|fxssf] gfd, y/ M
M

-s[kof kmf]6f]df
l:6r gug'{xf]nf_

-lk|k]8 df]afO{n 6]lnkmf]gsf] cfa]bg kmf/d_

================================================================================================================================

Customer's Name
(in BLOCK Letter) :-

@= u|fxssf] 7]ufgf (Customer's Address) M

-s_ :yfoL M
M lhNnf MM

uf=lj=;=gu/kflnsf M
M

-gful/stf cg';f/_

jf8{ g+=M

ufpm6f]nsf] gfd M
M

3/ g+= M

-v_ xfn a;f]af; ul//x]sf] M

M lhNnf MM

uf=lj=;=gu/kflnsf M
M

-:yfoL 7]ufgf eGbf km/s ePdf dfq _

jf8{ g+=M
ufpm6f]nsf] gfd M
M

#= ;+3;+:yfsf] gfddf h8fg ePdf

-s_ Kofg gDa/ M
M
$= u|fxssf] k]zf M
-s_ sfo{/tcWoog/t
tcWoog/t ;+:yfsf] gfd M
-v_ sfo{/tcWoog/t ;+:yfsf] 7]ufgf M
M
^= u|fxssf]
xssf] afa'kltsf] gfd M
M
&= u|fxssf]
xssf] afh]sf]f] gfd M
M
*= u|fxssf] ;Dks{ 6]lnkmf]g g+= M
M
!)= u|fxssf]
xssf] kl/ro M
M gful/stf g+=

3/ g+= M

-v_ ;Dks{ 6]lnkmf]g g+= M

%= ln M
k'?if

dlxnf

(= O{d]nM
M
===============================
====================================
=================== lhNnf =======================================
=======================================
kf;kf]6{ g+= -ljb]zL gful/ssf nfuL _ ======================== sDkgLkmd{ btf{ g+= =============================
=============================
-g]kfnL gful/ssf nfuL _

-kf;kf]6{ gePsf ef/tLo gful/sn] g]kfn clw/fHosf] nflu ef/tLo /fhb'tfjf;n] lbPsf] k|df0fkqsf] gDj/ pNn]v ug'{kg]{5 ._
-;+3;+:yfsf] xsdf btf{ k|df0fkqsf] gDa/ pNn]v ug'{ kg]{5 ._

-s_ dfly pNn]lvt Joxf]/f l7s ;frf] xf], em"flf 7x/]df sfg"g jdf]lhd ;x'nf a'emfpnf .
-v_ g]kfn 6]lnsdsf] k|rlnt tyf eljiodf sfod x'g] dx;'n b/, zt{ Pj+ gLlt lgodx? Kffngf ug]{5' .
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lhDd]jf/ x'g]5' .
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-_ df]afO{n 6]lnkmf]g x/fPdf tTsfn aGb ug{sf] nflu g]kfn 6]lnsddf lnlvt ;"rgf lbg] 5' .
-r_ JolQmsf] xsdf g]kfnL gful/stfsf] k|dfl0ft k|ltlnkL, lab]zLsf] xsdf kf;kf]6{sf] k|dfl0ft k|ltlnkL tyf ;+3;+:yfx?sf] xsdf btf{
k|df0fkqsf] k|dfl0ft k|ltlnkL o; cfj]bg kmf/d ;fy ;+nUg ug'{kg]{5 .

u|fxssf] b:tvt

;+3;+:yfsf] gfddf h8fg ePdf

g]kfnLdf M =========================

;+3;+:yf k|d'vsf] b:tvt M ==================

gfd M =======================================
kb M =====================================

c+uhLdf
]|hLdf M ===========================

sfof{nosf] 5fk M =========================

ldlt @)^

k|of]ustf{sf] cf}+7f 5fk

bfof

afof

sfof{no k|of]hgsf] nflu dfq

?h' ug]{sf]
b:tvt M

gfd M

Pre-paid Package Cost Rs.

SIM Card Serial Number:
Signature of Sale Personnel: ...

kb M
u|fxs ;]jf s]Gb| k|d'vsf] b:tvt M==================================
Receipt No. .

Date : 206 /

Mobile No.
Signature of Customer: