DISTRIBUTORS:-

To further strength on distribution channels, Urilab Systems-Diagnostics is looking all over India dynamic results oriented partners as distributors all over country.

Interested parties may fill up the form and send it on-line or the copy may be send to us by the fax or original by mail / courier at our address.


If you want to become the part of the 
URILAB SYSTEMS DIAGNOSTICS 
so please CLICK HERE FOR DISTRIBUTION SHIP FORM

 

 

 

 

 

 

 

 
 



 


DISTRIBUTION SHIP FORM



Your Name
>>
Phone No.
Office
>>
Residence
>>

(include country code & area code)
Fax No.
>>
(include country code & area code)
E-mail
>>
Address
>>
Zip Code / Postal code
>>
Country
>>
Company
>>
Existing dealership of our Co. (if any)
>>
if yes Name of the Co.
>>
Area Covered
>>
Drug Licence no.20 (B)
>>
Date
>>
Drug Licence no.21 (B)
>>
Date
>>
CST No.
>>
Date
>>
LST No.
>>
Date
>>
VAT No.
>>
Date
>>
Area Covered
>>
No. of Salesman / Managers / Engineers
>>
Present Turnover (Rs.)
>>
Sale tax / Income Tax Returns for last three years
>>
Yes No

Security amount (must) Rs.
depending upon the market potential (S.D. will attract nominal nationalized int. bank int.. rate as per R.B.I regulations.) 
>>
Details of any other business
Name
>>
Place
>>
Amount turnover(Rs.) / PA
>>
Remarks
>>