Select Date for Installation
Material Listed | Last Month Total Consumption | Day Wise Consumption | Max Stock Level in Days | Max Stock Level in Qty | In Hand Stock | Quantity to be supplied | Current number of days stock |
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Please select Suspension Date
Please select Resumption Date
Select Date for Field Repair
Product | Amount/Quantity |
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Evd |
Preferred Wallet Option |
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|
No of connections | |
Channel count |
Primary | Rs. |
Box Type | |
TSK Price | Rs. |
Pack | Rs. |
NCF | Rs. |
Secondary 1 | Rs. |
Box Type | |
TSK Price | Rs. |
Pack | Rs. |
NCF | Rs. |
Secondary 2 | Rs. |
Box Type | |
TSK Price | Rs. |
Pack | Rs. |
NCF | Rs. |
Secondary 3 | Rs. |
Box Type | |
TSK Price | Rs. |
Pack | Rs. |
NCF | Rs. |
Total | Rs. |
Select Date for Installation
Select Date for Installation
No of connections | |
Channel count |
Primary | Rs. |
Box Type | |
Pack | Rs. |
NCF | Rs. |
Secondary 1 | Rs. |
Box Type | |
Pack | Rs. |
NCF | Rs. |
Secondary 2 | Rs. |
Box Type | |
Pack | Rs. |
NCF | Rs. |
Secondary 3 | Rs. |
Box Type | |
Pack | Rs. |
NCF | Rs. |
Total | Rs. |
Note : The form above can be submitted only once per day.
Partner Code | Partner Name | Partner MDN | Requested Date | Area Pincode | Parent Code | Parent Mobile Number | Parent Name | Created By | Status |
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