Warranty Activation

Enter Details

Upload Image Of The Bill * Allowed file formats - jpg, jpeg, png

Date

Customer Name (With Initials) *

Customer Address *

Customer Mobile Number *

Customer Landline Number

Customer Email Address *

Make & Model *

Serial Number Ex: SNXXXX-XXXXX-XXXXXX (Location) *

Pharmacy Area *

Pharmacy Name *

Purchase Date *

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