1/48, RIICO Industrial Area KANAKPURA,

Near Kanakpura Rly Station, Sirsi Road,

Jaipur - 302034 (Raj.) INDIA
Contact No. : +91 9587816226
Web Site : www.credencelife.com
E-Mail : info@credencelife.com
....Caring Healthy & Wealthy Life GSTIN : 08AJMPS5842B1ZO

PRODUCTS ORDER FORM

Associate ID No. :________________________ Name ____________________________________
Mode of Payment : CASH BANK (in Favor of Credence Life Care) payable at Jaipur.
ICICI BANK, A/C NO.: 023505502014, IFS CODE : ICIC0000235 Branch : Vaishali Nagar, JAIPUR

S.N. Product Description Series P. Size MRP TCB QTY Amount

1 Feel Easy Sanitary Pad Health 10 pcs 350 100
2 Scorvit 9g Tablets Health 30 pcs 480 100
3 Gynex Capsules Health 20 pcs 500 125
4 NR Oil Health 50 ml 600 150
5 Anti Regulife Drop Health 30 ml 700 200
6 Noni Gold Juice Health 500 ml 800 200
7 Moringa Plus Veg Capsules Health 60 pcs 900 300
8 Flax Seed Oil Health 825 ml 1600 400
9 Mukda Veg Capsules Health 60 pcs 1800 500
10 Reanimate Detoxic Life Spray Health 20 ml 2000 750
11 Energy Twister Health 825 ml 2200 800
12 Protis Herbal Booster Health 1 kg 2200 800

Grand Total
Note : Buy any 2 on MRP and get 1 free*

Associate’s Sign. : _________________

Authorised Sign. & Seal : _________________

Date : _________________