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DIABETES PACK
PLEASE, SUPPLY THE CORRECT INFORMATION,FOR OUR AGENT TO EASILY CONTACT YOU FOR DELIVERY
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FULL NAME
*
Your answer
DELIVERY ADDRESS
*
Your answer
DATE OF DELIVERY
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DELIVER WITHIN 24HRS TO 48HRS
DELIVER IN THREE DAYS
STATE
*
Your answer
CITY
*
Your answer
PHONE NUMBER
*
Your answer
COST PRICE
*
#42,500
TERMS AND CONDITIONS
*
I AM READY TO RECEIVE MY MEDICATION
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