Order form untuk Lomo aquapix

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Full name
Gender	Female Male
No phone
Address
Link Facebook/Twitter/Blog
Code/Patterns	Winnie The pooh Spongebob Flowery Love Nemo Pink Orange Blue Green Purple Yellow Red White
Quantity of Camera
Quantity of Filem
Package
Paid via	ATM/Cash deposit Account Transfer
Date Paid
Time Paid
Total Paid Amount
Link Picture Bank slip
Any Question?

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