Piramal
Healthcare
Lacto Calamine Window Display: Agreement Form
Date : 2019-04-09
Docket No :
I hereby agree to allow display for Lacto Calamine for period of Days from the date of installation (not from date of booking) as per agreed terms & conditions at Rs. worth display gift(Total Payout).
Retailer Details :
Firm Name :
Add Line1 :
Add Line1 :
City :
State:
Pin:
Tel:
Beat Name:
Retailer DVL code:
Retailer gstn :
Note for Retailer :
- Please collect Duplicate copy of this enrolment form from field personnel.
- Please ensure hard copy of bill to be retained for validation.
- Please ensure photograph copy of display is retained.