KUPANG………….20 KUPANG………….

20

X – OES TREATMENT X – OES TREATMENT

JL. BANTENG NO.11 KUANINO JL. BANTENG NO.11 KUANINO
KEL.NUNLEU KEC.KOTA RAJA KEL.NUNLEU KEC.KOTA RAJA
KUPANG – NTT KUPANG – NTT
08111502033 08111502033
NO.TELEPON/HP: NO.TELEPON/HP:
ALAMAT : ALAMAT :
NO. NO.
SEPATU JML JENIS TREATMENT SEPATU JML JENIS TREATMENT
SEPATU SEPATU
IN OUT IN OUT

TOTAL Rp. TOTAL Rp.

TANDA TERIMA : HORMAT KAMI TANDA TERIMA : HORMAT KAMI

……………………….. X – OES TREATMENT ……………………….. X – OES TREATMENT

TANDA TERIMA :

ALAMAT
NO.TELEPON/HP:
IN

SEPATU
OUT

JML

JL. BANTENG NO.11 KUANINO

KEL.NUNLEU KEC.KOTA RAJA
SEPATU
JENIS

X – OES TREATMENT
TOTAL

KUPANG – NTT
08111502033
NO.

KUPANG………….20
HORMAT KAMI

TREATMENT
Rp.