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Name:
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Contact Number:
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Email Address:
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1st Item Code, Size, Color:
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1st Item Quantity:
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2nd Item Code, Size, Color:
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2nd Item Quantity:
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3rd Item Code, Size, Color:
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3rd Item Quantity:
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Delivery Method:
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Pos Express
Pos Laju
COD via Kuchai Lama
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Address: (Required for Pos method)
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Enquiries: (If Any)
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I have Read and Agree with the Terms and Conditions
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