! ' 31st Dec. Party Form !!

Name: - __________________ Age: - ____
Address: - ____________________

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Home phone number: - ____________

Type of drug: - __________________

Brand of drug: - ___________

What will you serve?

Water / soda / cool drink / ice

Stuff: - _____________________

(Nothing else): - ________________

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Type of meal: - ________________

What will eat?: - _________________

Fee as a party's assistant: only 1111

Signed

** Woman's permission document required **

Signature of wife

Note: The party's location is marked 2 days ago and 1000 and 500 notes are invalid

The consent of the wife and the signature of the spouse is done for the publication by the Nizhadam Admin.

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