ORDER LIST FORM

CUSTOMER NAME AGAGON, MARY JANE DATE: July 24, 2020

ADDRESS / CONTACT 1148, Unit 2, Kumintang ibaba Santuray road

DELIVERY
)atangas city X
MODE OF PAYMENT : CASH
(CASH OR CREDIT CARD)
Contact Number (atleast 2) : CUT-OFF TIME
+639394815655
AM

PM

QTY UNIT ITEM DESCRIPTION OTHER

SIZE
(No. of Items) (Pc/Pack) (Brand/Category/Variant) BRAND
2 pc Selecta fortified fresh milk 1L Nestle
2 pcs Century tuna hot and spicy 155 g

1 pcs Argentina cornedbeef 155 g

1 Pc Mega sardines hot and spicy

pcs 1 whole chicken 1kg

pcs Pork liempo Worth 200

pesos

1 pcs Eden cheese 165 g QUESO

12 pc Kopiko brown twin pack

pc Seafood Sub-O Cream dory (ung tig 200 pesos po and below)

5 Pc YAKISOBA ANY FLAVOR (UNG NAKA PACK PO)

IF WALA PANCIT CANTON SWEET AND SPICY

1 Pc Bestfoods mayonnaise 80 ml

2 Pcs All purpose nestle cream 250 ml

1 pcs Gardenia

1
pc

Kojie san ung ganto po

1 pcs Butter dairy cream 200 g

 Red Onion Isang supot
ung
nakabalot
na po

12 pcs Egg (ung tig 89 pesos po) medium

1 pc Ram breadcrumbs 230 g

1 UFC banana ketchup 320 g

1 pc carrot

1 Pc ampalaya

Siling labuyo (ung naka isang ballot po)

1 pc sayote

Note: *Kindly provide the complete details of your order.

*Order forms can be filled out either computerized or handwritten and should be sent online thru our
social media messaging applications

Nearest landmark: Batangas medical center

NOTE: IF NAG LUMAGPAS PO NG 2,1OO PESOS UNG TOTAL TANGGALING NALANG PO UNG BANANA
KETCHUP AND SILING LABUYO. IF EVER LANG NAMAN PO. MARAMING SALAMAT PO.