Serata Product Dropship Sign-Up Form
This is a sign-up form for clients of Serata who intends to join the Product Dropship program. We will contact you shortly after you submit the form for account verification.
For questions, please contact us at +628113357676 or info@serataraya.com. Thank you.
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Clinic/Hospital Name *
Prescriber Name (Dokter Penulis Resep) *
Doctor/Clinic Address
Doctor/Clinic City
Doctor/Clinic Province
Clinic Email *
Clinic Phone Number *
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