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Consigner Full Name (As per documents)*

Mobile No.*

Alt Mob

Country*

Province / Emirate*

Address*

Building / Flat / Villa No

Location*

Receiver Full Name (As per documents)*

Country*

State / Province*

Address*

Package Details

Pieces*

Approx. Weight (Kg)*

Package Type*

Service Type*

Preferred Pickup Date

Preferred Pickup Time

Remark*