O R D E R FORM.0903dc89-6edf-49b3-b48f-9f024816f7e7

Page 1

ORDER–FORM For Offline (Manual) booking (Booking Period – 01-04-2013 to 31-05-2013) To The General Manager, India Government Mint, Alipore, Kolkata – 700053.

Sir, Please book my order for Sl. No.

Name of Coin Set

Denominations of Coin Sets

Price Per Set Proof Coin Uncirculated Coin Set Set 4,414 3,955/-

1.

SWAMI VIVEKANANDA-150 Birth Anniversary(1863-1902)

2 Coins Set of 150/- & 5/-

2

60 YEARS OF INDIA GOVT. MINT, KOLKATA (1952-2012)

2 Coins Set of 60/- & 5/-

3,408/-

2,950/-

3.

60 YEARS OF INDIA GOVT. MINT, KOLKATA (1952-2012)

1 Coin Set ( 60/- )

2,944/-

-------

4.

SANT TUKARAM

4 Coin Set (Rs.100,Rs.50,Rs.10,Rs.2)

10,000

5,

DR. SHYAMA PRASAD MOOKERJEECENTENARY

4 Coin Set (Rs.100,Rs.50,Rs.10,Rs.2)

11,004

10,526

6.

LAL BAHADUR SHASTRI-BIRTH CENTENARY(1904-2004)

2 Coin Set-(Rs.100& Rs.5)

8,101

7,667

NAME OF COIN SET

NO. OF SETS ORDERED PROOF SETS UNC SETS

9,534`

TOTAL PRICE

Name (full in capital) ……………………………………………………………………………………………………………….. Postal address (full in capital): House No.………………………………………………Street…………………………. City……………………………………State: ……………………………………..Pin Code: ……………………………………..

Phone No …………………………………………….. Mobile No ………………………………………………………………..

Email ID: …………………………………………………………………………………………………………………………………..

D.D. No………………………………Date………………………………..Drawn on……………..............................


Turn static files into dynamic content formats.

Create a flipbook
Issuu converts static files into: digital portfolios, online yearbooks, online catalogs, digital photo albums and more. Sign up and create your flipbook.
O R D E R FORM.0903dc89-6edf-49b3-b48f-9f024816f7e7 by srinivasareddy R - Issuu