Products Enquiry/Order Form
Questions marked by * are required.
1.
Name of Product Ordered *
-
Panchgavya Organic Manure 5ml
Cow Milk Booster 400mg with Bottle
Cow Milk Booster 400mg
Dsalt 5grams
2.
Packing Quantity *
-
5ml
400mg
5grams
3.
No. of Pouches / Bottles required *
4.
Amount intended to be paid. (Price: Panchgavya 5ml Rs.700, DFA CMB 400mg in 60ml Bottle Rs.210, Dsalt 5grams Rs,800 *
5.
Desired mode of Payment
-
Through Bank Transfer
PhonePay
PayTm
online Payment
QR Code
other mode
6.
Your Name *
7.
Email: *
8.
Full Postal Address with Pin Code *
9.
Mobile/Phone Number *
10.
What Courier service is operating in your location? *
Professional Courier
Shree Tirupati Couriers
Delhivery Couriers
11.
Do you want to become an Agent for Our Products?
-
Yes
No
No idea
12.
Any other Information/Suggestions *