Vendor Form - MED-X

Vendor Details

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Vendor ID:

Why are you interested for Med-x?

Shall you refer med-x to your friend?

Yes

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Additional Bank Account Details:

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I do agree to bind myself by the governing rules of Med-X to act as vendor. I state and submit that the form submitted by me are all true to my best of knowledge and personal belief, and I have read and agree to the terms and conditions.

Vendor Details

Please fill up the vendor form!

MED-X

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