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Instructions:
Please provide the following contact information. (* required fields)

Hospital / Clinic/ Nursing Home / Company Name* :  

Contact Name*:  

Address (Line1):  

Address (Line2):  

City / State / Province /Country*: 

Postal Code / Zip: 

Phone Number :  

Fax Number :  

E-mail:  

Web address / URL (if any) 

Quotation Request for Item: (Example : Hospital Beds)


Model # X pieces

Would you like a sales person to contact you? YES NO

When would be a good time to call you?

How can we assist you? :

Would you like a brochure mailed to you? YES NO

   

 

TAJ INDUSTRIAL CORPORATION

2 Kiyani Shaheed Plaza, Off Garden Road, Karachi 74400 PAKISTAN.

 PH: +92(021) 3-225-1025 | Fax: +92(21) 3-225-4748

Copyright 2009 Taj Industrial Corporation. All rights reserved.