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.