Prescription Pads
Size : 5.5 x 6.5"
Number of sheets : 40 sheets per pad
Paper : White, 100 gsm
Minimum quantity per order : 10 pads per name/design
To order, please fill up the form at the bottom of this page and e-mail it to
ORDER FORM
Copy and fill up the order form below and e-mail it to :
Subject : “PRESCRIPTION PADS / YOUR NAME / DATE OF YOUR ORDER"
Complete Name :
Complete Shipping Address with Zip Code (if to be shipped to an office, please indicate company name):
Contact Number :
NAME # 1
Chosen Design :
Quantity (minimum of 5 pads per name/design) :
CONTENTS
Doctor's full name :
Spacialization :
Clinic's address:
Telephone number:
Clinic hours:
License number:
If there are 2 clinics, please fill up the information above again.
NAME # 2
Chosen Design :
Quantity (minimum of 5 pads per name/design) :
CONTENTS
Doctor's full name :
Spacialization :
Clinic's address:
Telephone number:
Clinic hours:
License number:
If there are 2 clinics, please fill up the information above again.
Note: If you are placing more than one order, please combine them all in one email, just please place a number on each order as seen above.