Sales Order Form

Sales Order Form

Anton Coetsee - Independent OxyCare Agent

(Cell: 078 456 4787)
Date*

DayMonthYear
OxyCare Sales Order Form
Customer/Account Information
Contact Name*

First NameLast Name
Phone Number*
Cell Phone Number
Email Address*
example@example.com
Shipping Address
Address*

Street Address

Street Address Line 2

CityProvince

Postal Code
ORDER INFORMATION
OxyCare Product List
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OxyCare Drops
10ml Bottle (1 x Month's Supply)

160.00ZAR Quantity
Item subtotal:0.00ZAR



OxyCare Eye Drops
20ml Dropper Bottle

160.00ZAR Quantity
Item subtotal:0.00ZAR



OxyCare Nasal Spray
30ml Nasal Spray Bottle

160.00ZAR Quantity
Item subtotal:0.00ZAR



OxyCare Spray
100ml Spray Bottle

160.00ZAR Quantity
Item subtotal:0.00ZAR



OxyCare Cramp Medicine
500ml Bottle

160.00ZAR Quantity
Item subtotal:0.00ZAR



OxyCare Cream
100ml Container

160.00ZAR Quantity
Item subtotal:0.00ZAR



OxyVita
30 Capsules

160.00ZAR Quantity
Item subtotal:0.00ZAR



OxyPain
30 Capsules

160.00ZAR Quantity
Item subtotal:0.00ZAR



OxySkin
30 Capsules

160.00ZAR Quantity
Item subtotal:0.00ZAR



OxyMoringa
30 Capsules

160.00ZAR Quantity
Item subtotal:0.00ZAR



OxyHair
100ml Spray Bottle

160.00ZAR Quantity
Item subtotal:0.00ZAR



Courier Guy Courier Service
Add Courier Guy Courier Cost for delivery to your physical address

70.00ZAR



Total

0.00ZAR

We accept payment by EFT

or

Cash on Delivery by arrangement only.

Our Banking details are:

Mrs. C Coetsee

Capitec Bank

Savings Account

Acc. Nr. 154 689 2778

Message us on WhatsApp after you have completed your order with: "Order Placed"
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