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Order card KH107
Quantity
ordered
Name of article Cost p. Unit Total sum
Set of 8
Brushheads for:
KH107
Toothbrush
£ 7,- £
Payment method
(Signature)
Sender / Orderer
(please complete in block capitals)
Surname, first name
Street
Post code/town
Telephone
£
Cheque payment
Add. £ 3,50 p&p.
Bank Transfer
Creditcard/Debitcard
(Location, Date)
✄
IB_KH107_E269_UK_4A 30.08.2007 13:45 Uhr Seite 11