
Client Name & Address:
Samantha Pushpakumara
68/79 Suramya Sewana, Pudupagala, Mandawala, Dompe
0712210372
| # | Product | Qty |
|---|---|---|
| 1 | 76 | 1 |
| 2 | 41 | 1 |
| 3 | 40 | 1 |
| 4 | 2 | 20 |
| 5 | 36 | 1 |
By (Name & Signature)
Authorized By