|
|
CARE N' HOME MEDICAL SUPPLY INC. | ||
| 3050 E Desert Inn Road, Suite 114 | Phone: | (702) 696-1527 | |
| Las Vegas NV 89121 | Fax: | (702) 696-1591 | |
|
REPORT
|
||||||||||||||||||||
|
||||||||||||||||||||
|
|
|
|
|
|
|
||||||||||||||
|
REPORT |
||||||||||||||||||||
Subject: Business Inquiry
Title: Mr.
First: Dele
Last: Aribibola
Address: 3524 Test Drive
City: Las Vegas
State: NV
Zip: 89147
AreaCode: 702-2224245
Phone:
FaxAREA:
FaxPhone1:
Email: dele.aribibola@uhsinc.com
HowDidYouHearAboutUs: Newspaper
Equipment: Oxygen
Style: Oxygen = Cylinder Tank
Quantity: 1
Item_discription:
paymenttype: Credit Card
CreditCard_no: 55512122215
ExpDate: 08/06
LocalAddress: Rio Hotel
ArrivalDate: 05/25/05
DeliveryPoint: lobby
Room_no: 3528
DepartureDate: 05/28/05
Pickupdate: 05/28/05
ShipMethodID: To Be delivered
Submit: Submit Application
This is just a Test from Dele
Subject: Business Inquiry
Title: Mr.
First: Dele
Last: Dele
Address: 3254 south Rainbow Blv
City: LAs Vgeas
State: NV
Zip: 89147
AreaCode: 702
Phone: 235-9210
FaxAREA:
FaxPhone1:
Email: dele@aol.com
HowDidYouHearAboutUs: Search Engine
Equipment: Oxygen
Style: Oxygen = Concentrator
Quantity: 2
Item_discription: Test
paymenttype: Phone Order (Call Me)
CreditCard_no: 5241725151
ExpDate: 05/08
LocalAddress:
ArrivalDate:
DeliveryPoint:
Room_no:
DepartureDate:
Pickupdate:
ShipMethodID: To Be delivered
Submit: Submit Application
This is Just a Test
Subject: Business Inquiry
Title:
First:
Last:
Address:
City:
State:
Zip:
AreaCode:
Phone:
FaxAREA:
FaxPhone1:
Email:
HowDidYouHearAboutUs: Search Engine
Equipment: Aid
Style: Aid = Walker
Quantity: 1
Item_discription:
paymenttype: Credit Card
CreditCard_no:
ExpDate:
LocalAddress:
ArrivalDate:
DeliveryPoint:
Room_no:
DepartureDate:
Pickupdate:
ShipMethodID: To Be delivered
Submit: Submit Application
Subject: Business Inquiry
Title:
First:
Last:
Address:
City:
State:
Zip:
AreaCode:
Phone:
FaxAREA:
FaxPhone1:
Email:
HowDidYouHearAboutUs: Search Engine
Equipment: Aid
Style: Aid = Walker
Quantity: 1
Item_discription:
paymenttype: Credit Card
CreditCard_no:
ExpDate:
LocalAddress:
ArrivalDate:
DeliveryPoint:
Room_no:
DepartureDate:
Pickupdate:
ShipMethodID: To Be delivered
Submit: Submit Application
Subject: Business Inquiry
Title: Mr.
First: mike
Last: abcd
Address: 555 abs clane
City: Las vegas
State: NEVA
Zip: 89121
AreaCode: 702
Phone: 555-15212
FaxAREA:
FaxPhone1:
Email:
HowDidYouHearAboutUs: Fax
Equipment: Oxygen
Style: Oxygen=Nebulizer
Quantity: 3
Item_discription:
paymenttype: Credit Card
CreditCard_no:
ExpDate:
LocalAddress:
ArrivalDate:
DeliveryPoint:
Room_no:
DepartureDate:
Pickupdate:
ShipMethodID: Customer Will Pick UP
Submit: Submit Application