Amul Order Form
Client Information
Name
First Name
Last Name
Phone Number
-
Area Code
Phone Number
Email
example@example.com
Date & Time
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Flat Details
Building Number
Floor
Flat No
State / Province
Postal / Zip Code
Menu
Order Table
Rows
Quantity
Amount
Amul 100 gms Butter (MRP- 48 ) (Price-46)
Amul 500 gms Butter (MRP- 235 ) (Price-225)
Amul cheese cube 40 pc pk (MRP- 505 ) (Price-490)
Amul 1kg processed cheese block (MRP- 453 ) (Price-435)
Amul 10 pc cheese slices (MRP- 122 ) (Price-117)
Amul 200 gm cheese spread (plain) (MRP- 85 ) (Price-82)
Amul 1 L ghee tin @ (MRP- 535 ) (Price-520)
Amul 1 L ghee refill @ (MRP- 520 ) (Price-505)
Amul Gold Milk 1L Tetrapack (MRP- 68 ) (Price-66)
Amul Taaza Milk 1L Tetrapack (MRP- 64 ) (Price-62)
Amul 150 Gm Hazelnut Chocolate (MRP- 200 ) (Price-180)
Amul 150 Gm Dark Chocolate (MRP- 100 ) (Price-90)
Amul 150 Gm Tropical Orange Chocolate (MRP- 125 ) (Price-115)
Amulya 200 gm pouch (MRP- 80 ) (Price-77)
Amulya 500 gm pouch (MRP- 197 ) (Price-190)
Amul 200 gm Malai Paneer Diced (MRP- 75 ) (Price-72)
Amul 180 ml Masti butter milk (MRP- 10 ) (Price-10)
Ice Cream 1L (Vanilla) (MRP- 110 ) (Price-100)
Ice Cream 750 ml (Alfonso Mango) 1+1 (MRP- 220 ) (Price-200)
Ice Cream 750 ml (Butter Scotch) 1+1 (MRP- 230 ) (Price-210)
Ice Cream 750 ml (Chocolate) 1+1 (MRP- 230 ) (Price-210)
Ice Cream 750 ml (Cookies & Cream) 1+1 (MRP- 240 ) (Price-220)
Ice Cream 750 ml (Tuti Fruti) 1+1 (MRP- 220 ) (Price-200)
Ice Cream 1 L (Kesar Badam) (MRP- 200 ) (Price-180)
Payment Information
Total Amount
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