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* Indicates required question
Shop/Company Name
*
Your answer
Company Registration Number
*
Your answer
Shop/Cafe Address
*
Your answer
Contact No.
*
Your answer
Name & Designation
*
Your answer
Weekly Coffee Bean Consumption
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< 3KG
> 3KG
> 5KG
> 10KG
> 15KG
Remarks/Additional Message
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