SR.
CUSTOMER DETAILS
Customer Name
Ishwar paudel
Card No:
E-Mail:
Ph. 9704598000 Mobile:
VEHICLE DETAILS
| VIN: | |
| MAKE: | |
| MODEL: | Ford |
| COLOUR: | |
| CHASSIS No.: | |
| REGD. No.: | |
| KMS: | |
| SALE DATE: |
RO NO:
RO-0292
RO DATE & TIME:
19-07-2026 10:40
BS: 2083-04-03 04:55
BS: 2083-04-03 04:55
PROMISED DATE & TIME:
ESTIMATION AMT:
ADVISOR:
Ranjan rauniyar
CUSTOMER REQUEST
DIAGNOSIS/WORK INSTRUCTION
MENU/OPERATIONS PERFORMED
1
Wiper blade change and cooltech change
SR.
PART NO
PART NAME
QTY
1
3834M82P00-000
Wiper blade
1.00
2
Coolent
2.00
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:
Time Out:
Supervisor's Signature: __________
Time In:
Time Out:
Supervisor's Signature: __________
BILL NO.:
DATE:
GP NO.:
DATE:
DATE:
GP NO.:
DATE: