SR.
CUSTOMER DETAILS
Customer Name
ASIAN LIFE INSURANCE COMPANY C/O SONALA SAHANI
Card No: 2810283016
E-Mail:
Ph. 9855033220 Mobile: 9855033220
VEHICLE DETAILS
| VIN: | MALB251CLNM280254 |
| MAKE: | Hyundai |
| MODEL: | Grand i10 Nios Magna |
| COLOUR: | |
| CHASSIS No.: | G4LANM144470 |
| REGD. No.: | BA PR 01 027 CHA 5677 |
| KMS: | |
| SALE DATE: |
RO NO:
RO-0188
RO DATE & TIME:
21-06-2026 17:36
BS: 2083-03-07 11:51
BS: 2083-03-07 11:51
PROMISED DATE & TIME:
ESTIMATION AMT:
ADVISOR:
Ranjan rauniyar
CUSTOMER REQUEST
DIAGNOSIS/WORK INSTRUCTION
MENU/OPERATIONS PERFORMED
1
Washing
PMS REMARK
Tech/F.S.Sig.
Sambhu
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: Sambhu
Time In: 5:38 p.m.
Time Out:
Supervisor's Signature: __________
Time In: 5:38 p.m.
Time Out:
Supervisor's Signature: __________
BILL NO.:
DATE:
GP NO.:
DATE:
DATE:
GP NO.:
DATE: