| Title(Prof./Dr./Mr./Mrs./Miss.): ................................................................................. |
Name: .......................................................................................................................... |
Address: ......................................................................................................................
.....................................................................................................................................
..................................................................................................................................... |
Postal Code: ....................................... Country: ........................................................ |
Telephone: .................................................................................................................. |
Fax: ............................................................................................................................. |
Email address: ............................................................................................................ |
Research Interest: ......................................................................................................
..................................................................................................................................... |
|
Method of Payment (Bank Draft/Cheque/Postal Order) No.: ....................................
(payable to TOTAL HEALTH CONCEPT SDN BHD) |
|
| Signature: ................................................. |
|
| Journal Information |
Issue: |
| 1) ........................................................ |
Unit: ............... |
Amount(RM): ........................ |
| 2) ........................................................ |
Unit: ............... |
Amount(RM): ........................ |
| 3) ........................................................ |
Unit: ............... |
Amount(RM): ........................ |
| |
Total Amount (RM): ...................................... |
|
|
The journal price is not including postage charges. For order outside Malaysia please add US$5.00 and RM5.00 for order inside Malaysia.
This order form should be sent to Tropical Botanics Sdn. Bhd., c/o: Total Health Concept Sdn. Bhd., No. 54, Jalan SS2/72,47300 Petaling Jaya, Selangor Darul Ehsan, Malaysia. |
