Komal Health Care Pvt Ltd

Business Enquiry Form

Contact Details

Business Enquiry / Quotation Request Form

To: Komal Health Care Pvt Ltd

*Please describe your specific/customized requirements:

Estimated Quantity:

When do you plan to purchase?

Immediately

1 Month

2 Month

3 Month

3+ Month

(Why we need your contact information)

Your Contact Information

Company Name:

*Contact Person:

*E-mail:

*Phone/Mobile:

Country code		Area code		Phone Number

Fax:

Business Address:

City/State:		Zip/Postal Code:

How would you like us to contact you:

Phone

Fax

*Country:

*Enter the code shown on image:


	Keep viewing this section for helpful tips. (* represents compulsory fields)

Business Enquiry Form

Contact Details

Mr. Paresh Goti
Komal Health Care Pvt Ltd
F-118, Gaurav Garden, Mira-Bhayander Road, Mira Road (East)
Thane - 401107, Maharashtra, India
Phone: +(91)-(22)-28124444 / 28197777
Fax: +(91)-(22)-28552555
Mobile: +(91)-9323456100
Email: ursgoti@yahoo.com

--- Products ---