Order Form :: CRM

Please Fill This Form Carefully To Place Your Order

Please only fill this form if you are 100% ready to pay and receive your order.

If you’re not ready, don’t fill out the form. Instead, save our number and Call or Chat Us on WhatsApp via 09166815536 OR 09163045510 later when you’re ready.

If you’re available and have the money to pay for your order, go ahead and fill out the form. Our delivery person will contact you to deliver your order on the exact date you specify. Thank you!

FIRST NAME *

LAST NAME *

PHONE NUMBER *

WHATSAPP NUMBER

FULL DELIVERY ADDRESS (Include Your City And Street) *

SELECT THE STATE YOU LIVE IN *

Select The Local Government Area (Optional)

Select When You Want Us to Deliver Your Order *

ACTIVE EMAIL (Optional)

SELECT THE QUANTITY YOU NEED FROM THE OPTIONS BELOW

1 Bottle of Fatty Liver & Hepatitis Capsule Combo'

Naira25000

1 Bottle of Fatty Liver & Hepatitis Capsule

2 Bottles of Fatty Liver & Hepatitis Capsule Combo'

Naira45000

2 Bottles of Fatty Liver & Hepatitis Capsule

3 Bottles of Fatty Liver & Hepatitis Capsule Combo'

Naira65000

3 Bottles of Fatty Liver & Hepatitis Capsule