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PHIU NG K MUA HNG

M PHIU:

L /./______________________

S LNG:

THNG TIN KHCH HNG:


H v tn: Sinh ngy:.............
S CMND: . Ngy cp: .. Ni cp:
in thoi: .. Email: ..................................
S ti khon: . Ngn hng: ...........................
H tn ngi gii thiu: ..M s gii thiu: ......
H tn ngi ch nh: . M s ch nh: .......
, Ngy .. thng . Nm 2015
Khch hng
(K & ghi r h tn)

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