ORDER FORM

FILL IN THE FORM AND SUBMIT

FOR YOUR CONVENIENCE THE PRODUCT PAGE IS ATTACHED BELOW 

Please fill the form and Submit.

FIRST NAME

DD in favour of ORTHO CARE PRODUCTS (P)Ltd payable at Perumbavoor, Kerala, India.

DD may be sent by courier to...

ORTHO CARE PRODUCTS (P)Ltd,
Pioneer Complex,
Opposite Private Bus Station,
Pin - 683542,
Perumbavoor,
Ernakulam,Kerala,
India.

LAST NAME

POSTAL ADDRESS

PIN CODE

TELEPHONE

FAX 

TELEX

E-MAIL 

WEBSITE

ITEM NAME

SIZE
DD Details
DD No.
DATE
BANK
AMOUNT
Money Transfer
To account No.cd1162, Federal Bank, Perumbavoor, Kerala, India. 
RECEIPT No.
DATE
BANK
AMOUNT
 

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