A SERVICE OF

logo

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_3 03.09.2007 9:53 Uhr Seite 11