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Paracetamol Tablet 500mg (Pack of 100 X 10 tablets) Order Form
RM70.00 / pack
* Indicates required question
Requestor / Person-in-Charge Name
*
Your answer
Clinic / Hospital Name
*
Your answer
Complete Address
(for delivery purpose)
*
Your answer
Email Address
*
Your answer
Phone Number
*
Your answer
Average Usage per Month
(number of tablets)
*
Your answer
Order Quantity
(Pack of 100 X 10 tablets)
*
Your answer
Disclaimer:
Pharmaniaga may not be able to deliver the full quantity requested. The program is based on quantity allocated by Ministry of Health.
Product ordered and delivered is
not returnable
.
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