SR.
CUSTOMER DETAILS
Customer Name
National medical clz/Abid hussain ansari
Card No:
E-Mail:
Ph. 9855020625 Mobile: 9855020625
VEHICLE DETAILS
| VIN: | MALC381CLHM284404 |
| MAKE: | Hyundai |
| MODEL: | Creta |
| COLOUR: | Sleek silver |
| CHASSIS No.: | G4FGHW489070 |
| REGD. No.: | Ba 18 cha 1100 |
| KMS: | |
| SALE DATE: |
RO NO:
RO-0178
RO DATE & TIME:
17-06-2026 16:10
BS: 2083-03-03 10:25
BS: 2083-03-03 10:25
PROMISED DATE & TIME:
ESTIMATION AMT:
ADVISOR:
Ranjan rauniyar
CUSTOMER REQUEST
DIAGNOSIS/WORK INSTRUCTION
MENU/OPERATIONS PERFORMED
1
Pulley beyring change
PMS REMARK
Tech/F.S.Sig.
Balram chaudhary
OTHER OBSERVATIONS
EF
| Service Booklet | ✓ |
| Spare Wheel | ✓ |
| Jack & Handle | ✓ |
| Toolkit | ✓ |
| Mats | ✓ |
| Mud Flaps | ✓ |
| Stereo | ✓ |
| Clock | ☐ |
| Wheel Cover | ✓ |
I hereby authorize the above work to be done with necessary Material & Additional work if required shall also at my cost.
Customer's Signature
Customer's Signature
On completion of above work, I have taken the trial to my vehicle and satisfied with the work done.
Signature __________ Date: __________
Authorised Signatory
Signature __________ Date: __________
Authorised Signatory
DELIVERY ONLY ON ACCEPTANCE OF CASH/DO OR P.O. SHOULD BE IN THE NAME OF
SANIYA ENTERPRISES PVT. LTD.
SANIYA ENTERPRISES PVT. LTD.
Mech's Name: Balram chaudhary
Time In: 4:11 p.m.
Time Out:
Supervisor's Signature: __________
Time In: 4:11 p.m.
Time Out:
Supervisor's Signature: __________
BILL NO.:
DATE:
GP NO.:
DATE:
DATE:
GP NO.:
DATE: