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CENTRAL MEDICAL STORES TRUST SPECIAL ORDER FORM
Please each submission should contain Maximum of 50 line items.
No.
Item Description
Unit of Issue
Quantity
1
Select Order Type:
Select Order Type
Special
Select Your Region:
Select your Region
North
Centre
South
Central Hospital
CHAM North
CHAM Centre
CHAM South
Pvt North
Pvt Centre
Pvt South
Faith Based South
NGO South
OTHER South
Select Your Health Facility:
+ Add More
Submit
Note: when you click submit, wait for 1 minute for the system to process the order
Order For Facility:
Health Facility/Centre
Central Hospital
District Hospital
Health Centres
SLA Hospital
Mponela Rural Hospital
Monkey Bay Community Hospital
Subtotal:
MWK
Total:
MWK
Amount Due:
MWK