g]kfn 6]lnsd k|of]ustf{sf]

kf;kf]6{
;fO{hsf] kmf]6f]
-g]kfn b"/;~rf/ sDkgL lnld6]8_

sfof{no k|of]hgsf] nflu df]afOn ;]jf lgb]{zgfno -s[kof kmf]6f]df

l:6r gug'{xf]nf_
btf{ g+=
-3G df]afO{n 6]lnkmf]gsf] cfa]bg kmf/d_
ldlt
!= u|fxssf] gfd, y/ M–
M– ================================================================================================================================
Customer's Name
(in BLOCK Letter) :-
@= u|fxssf] 7]ufgf (Customer's Address) M
-s_ :yfoL M–
M– lhNnf M–M– uf=lj=;=÷gu/kflnsf M–
M–
-gful/stf cg';f/_
jf8{ g+=M–
M– ufpm“÷6f]nsf] gfd M–
M– 3/ g+= M–
M–
-v_ xfn a;f]af; ul//x]sf] M–
M– lhNnf M–M– uf=lj=;=÷gu/kflnsf M–
M–
-:yfoL 7]ufgf eGbf km/s ePdf dfq _
jf8{ g+=M–
M– ufpm“÷6f]nsf] gfd M–
M– 3/ g+= M–
M–
#= ;+3÷;+:yfsf] gfddf h8fg ePdf
-s_ Kofg gDa/ M– M– -v_ ;Dks{ 6]lnkmf]g g+= M
$= u|fxssf] k]zf M–
M– %= lnË M k'?if dlxnf
-s_ sfo{/t÷cWoog/t ;+:yfsf] gfd M–
-v_ sfo{/t÷cWoog/t ;+:yfsf] 7]ufgf M–
M–
^= u|fxssf] afa'÷kltsf] gfd M–
M–
&= u|fxssf] afh]sf] gfd M–
M–
*= u|fxssf] ;Dks{ 6]lnkmf]g g+= M–
M– (= O{–d]nM–
M–
!)= u|fxssf] kl/ro M–
M– gful/stf g+= -g]kfnL gful/ssf nfuL _ ==================================== lhNnf =======================================
kf;kf]6{ g+= -ljb]zL gful/ssf nfuL _ ======================== sDkgL÷kmd{ btf{ g+= =============================
-kf;kf]6{ gePsf ef/tLo gful/sn] g]kfn clw/fHosf] nflu ef/tLo /fhb'tfjf;n] lbPsf] k|df0f–kqsf] gDj/ pNn]v ug'{kg]{5 ._
-;+3–;+:yfsf] xsdf btf{ k|df0fkqsf] gDa/ pNn]v ug'{ kg]{5 ._
-s_ dfly pNn]lvt Joxf]/f l7s ;f“rf] xf], em"flf 7x/]df sfg"g jdf]lhd ;x'“nf a'emfp“nf .
-v_ g]kfn 6]lnsdsf] k|rlnt tyf eljiodf sfod x'g] dx;'n b/, zt{ Pj+ gLlt lgodx? Kffngf ug]{5' .
-u_ d]/f] gfddf btf{ ePsf] df]afO{n 6]lnkmf]gjf6 c? s;}n] k|of]u u/L s'g} b'?kof]u jf clgoldt sfo{ ePdf ;d]t sfg"g jdf]lhd k"0f{ ?kdf
lhDd]jf/ x'g]5' .
-3_ cglws[t ?kdf jf zt{ ljkl/t ;]jf pkef]u u/]sf] sf/0fn] b"/;~rf/ P]g @)%# sf] bkmf $#-u_ cg';f/ ;]jf jGb u/]df d]/f] d~h'/L 5 .
-ª_ df]afO{n 6]lnkmf]g x/fPdf tTsfn aGb ug{sf] nflu g]kfn 6]lnsddf lnlvt ;"rgf lbg] 5' .
-r_ JolQmsf] xsdf g]kfnL gful/stfsf] k|dfl0ft k|ltlnkL, lab]zLsf] xsdf kf;kf]6{sf] k|dfl0ft k|ltlnkL tyf ;+3–;+:yfx?sf] xsdf btf{
k|df0fkqsf] k|dfl0ft k|ltlnkL o; cfj]bg kmf/d ;fy ;+nUg ug'{kg]{5 .
u|fxssf] b:tvt ;+3÷;+:yfsf] gfddf h8fg ePdf
g]kfnLdf M ========================= ;+3–;+:yf k|d'vsf] b:tvt M ================== k|of]ustf{sf] cf}+7f 5fk
gfd M =======================================
kb M =====================================
c+u|]hLdf
Ldf M =========================== sfof{nosf] 5fk M =========================
ldlt @)^ ÷ ÷ bfof“ afof“

sfof{no k|of]hgsf] nflu dfq

?h' ug]{sf]
b:tvt M gfd M kb M
u|fxs ;]jf s]Gb| k|d'vsf] b:tvt M==================================
USIM Card Cost Rs. ……………………… Receipt No. ………………. Date : 206 / /
Deposit Rs………………………..
USIM Card Serial Number: Mobile No.

Signature of Sale Personnel: ………….………….. Signature of Customer: ………………………………