Grocery Order Form
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Apple
Fruits makes you beautiful
$
10.00
kg
0
1
2
3
4
5
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8
9
10
Color
Red
Green
Banana
Your protein supplement; banana
$
5.00
kg
0
1
2
3
4
5
6
7
8
9
10
Apricot
Have fruits your tummy loves it
$
12.00
kg
0
1
2
3
4
5
6
7
8
9
10
Cherry
Fruit for every mood
$
20.00
kg
0
1
2
3
4
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8
9
10
Avocado
100% original
$
5.00
per number
0
1
2
3
4
5
6
7
8
9
10
Cucumber
Eat fresh, stay healthy
$
12.00
kg
0
1
2
3
4
5
6
7
8
9
10
Lettuce
Make green compulsory
$
5.00
per number
0
1
2
3
4
5
6
7
8
9
10
Sweet Potato
Never say no to vegetables
$
2.00
per number
0
1
2
3
4
5
6
7
8
9
10
Tomato
Vegetables for long life
$
5.00
kg
0
1
2
3
4
5
6
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8
9
10
Customer Name
First Name
Last Name
Phone Number
Email
example@example.com
Delivery Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Order
Should be Empty: