Full name

date

Telephone

Fax

E-mail

Country

Address

Ship to

Country

Invoice to (if different than the previous)

Country

Purchase order No.

delivered before (mm / dd / yy)

Payment by

T/T

L/C

Check

Other

Please use our DHL Global Account Number for this shipment

Product catalog No	Description	Quantities	Unit price (USD FOB Beijing)

Total

We would like the items to be packed and labeled as

Original labeling and packing

OEM, and we have the following requirements

regarding the OEM packing

We would like to order ELISA kits in the following format

48 well/ kit

96 well /kit

480 well/ kit

We would like to order ELISA kits with the following microwell plate configuration

12 strips X 8 wells

8 strips X 12 wells

Remarks, additional requests or special instructions