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	Sample Orders
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<div>
<input type="hidden" name="__EVENTTARGET" id="__EVENTTARGET" value="">
<input type="hidden" name="__EVENTARGUMENT" id="__EVENTARGUMENT" value="">
<input type="hidden" name="__VIEWSTATE" id="__VIEWSTATE" value="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">
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            <input type="hidden" name="hdnTaskAttachments" id="hdnTaskAttachments" value="template for samples orders.xlsx">
            <input type="hidden" name="hdsTaskComment" id="hdsTaskComment" value="attached please find sample form.  ">     
            <input type="hidden" name="hdFirstForm" id="hdFirstForm" value="0">
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<table width="100%" style="background-color: #E5E5E5;">
    <tr>
        <td align="left">
            <div>
                <h4>
                    <span id="PageLayout_UC1_lblFormPageTitle">Sample Orders</span>
                </h4>
            </div>
        </td>
        <td align="right">
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                <input name="PageLayout_UC1$hdntargetcellid" type="hidden" id="PageLayout_UC1_hdntargetcellid">
                
                
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    <tr>
        <td colspan="2">
            
        </td>
    </tr>
</table>

<div id="PageLayout_UC1_plcFormDesigner" class="overflow_formbuilder" style="width:100%;direction:ltr;">

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                <table cellpadding="0" cellspacing="1" border="0" class="content_table no-bord tbl_layout"><tr><td></td><td></td><td></td><td></td><td colspan="2"></td><td></td><td></td></tr><tr><td></td><td></td><td colspan="2"></td><td></td><td></td><td></td><td></td></tr><tr><td></td><td></td><td></td><td></td><td><table cellpadding="0" class="content_table" cellspacing="1" border="0"><tr><td class="label" style="WhiteSpace:nowrap;"><span id="lblwfLabel15238">Product Type</span></td></tr></table></td><td><table cellpadding="0" class="content_table" cellspacing="1" border="0"><tr><td><table id="ctrlProductlist" border="0" style="height:16px;width:400px;">
		<tr>
			<td><span><input id="ctrlProductlist_0" type="radio" name="ctrlProductlist" value="6053" checked="checked" checked="checked"><label for="ctrlProductlist_0">Calcium Carbonate</label></span></td><td><span><input id="ctrlProductlist_1" type="radio" name="ctrlProductlist" value="6054"><label for="ctrlProductlist_1">MICSMART</label></span></td><td><span><input id="ctrlProductlist_2" type="radio" name="ctrlProductlist" value="6055"><label for="ctrlProductlist_2">MICShield</label></span></td><td><span><input id="ctrlProductlist_3" type="radio" name="ctrlProductlist" value="6056"><label for="ctrlProductlist_3">Animax</label></span></td><td><span><input id="ctrlProductlist_4" type="radio" name="ctrlProductlist" value="6057"><label for="ctrlProductlist_4">Ultra</label></span></td>
		</tr>
	</table><span id="ctl10" style="color:Red;display:none;"></span></td></tr></table></td><td></td><td></td></tr><tr><td></td><td></td><td></td><td></td><td><table cellpadding="0" class="content_table" cellspacing="1" border="0"><tr><td class="label" style="WhiteSpace:nowrap;"><span id="lblwfLabel15228">Customer name </span></td></tr></table></td><td><table cellpadding="0" class="content_table" cellspacing="1" border="0"><tr><td><input name="wfTextBoxOnly15233" type="text" value="RAFIA INDUSTRIAL SA" maxlength="60" id="wfTextBoxOnly15233" sectionid="-1" groupid="" fbcontrolid="15233" controlid="wfTextBoxOnly15233" style="height:20px;width:400px;"></td></tr></table></td><td></td><td></td></tr><tr><td></td><td></td><td></td><td></td><td><table cellpadding="0" class="content_table" cellspacing="1" border="0"><tr><td class="label" style="WhiteSpace:nowrap;"><span id="lblwfLabel15229">Customer contact Details</span></td></tr></table></td><td><table cellpadding="0" class="content_table" cellspacing="1" border="0"><tr><td><input name="wfTextBoxOnly15234" type="text" value="Mr. Sebastian, (+34)961491081" maxlength="60" id="wfTextBoxOnly15234" sectionid="-1" groupid="" fbcontrolid="15234" controlid="wfTextBoxOnly15234" style="height:20px;width:400px;"></td></tr></table></td><td></td><td></td></tr><tr><td></td><td></td><td></td><td></td><td><table cellpadding="0" class="content_table" cellspacing="1" border="0"><tr><td class="label" style="WhiteSpace:nowrap;"><span id="lblwfLabel15230">Customer delivery Address</span></td></tr></table></td><td><table cellpadding="0" class="content_table" cellspacing="1" border="0"><tr><td><textarea name="wfTextBoxOnly15235" rows="2" cols="20" id="wfTextBoxOnly15235" sectionid="-1" groupid="" fbcontrolid="15235" controlid="wfTextBoxOnly15235" style="height:60px;width:400px;">RAFIA INDUSTRIAL S.A.
Carrer Foios 1
46114 Vinalesa (Valencia)
SPAIN,</textarea></td></tr></table></td><td></td><td></td></tr><tr><td></td><td></td><td></td><td></td><td><table cellpadding="0" class="content_table" cellspacing="1" border="0"><tr><td class="label" style="WhiteSpace:nowrap;"><span id="lblwfLabel15231">Expected Delivery Date</span></td></tr></table></td><td><table cellpadding="0" class="content_table" cellspacing="1" border="0"><tr><td><input name="wfTextBoxOnly15236" type="text" value="08/03/2023" id="wfTextBoxOnly15236" title="Test Calender" onkeypress="return ValidateDate(this)" fbcontrolid="15236" controlid="wfTextBoxOnly15236" style="height:20px;width:150px;"><input type="image" name="wfTextBoxOnly15236imgbtn" id="wfTextBoxOnly15236imgbtn" title="Select Date" src="../../App_Themes/images/date.gif" style="border-width:0px;"><span id="wfTextBoxOnly15236rfv" style="color:Red;display:none;"></span><span id="wfTextBoxOnly15236dv" style="color:Red;display:none;"></span></td></tr></table></td><td></td><td></td></tr><tr><td></td><td></td><td></td><td></td><td><table cellpadding="0" class="content_table" cellspacing="1" border="0"><tr><td class="label" style="WhiteSpace:nowrap;"><span id="lblwfLabel15232">Actual Shipping Date</span></td></tr></table></td><td><table cellpadding="0" class="content_table" cellspacing="1" border="0"><tr><td><input name="wfTextBoxOnly15237" type="text" value="08/03/2023" id="wfTextBoxOnly15237" title="Test Calender" onkeypress="return ValidateDate(this)" fbcontrolid="15237" controlid="wfTextBoxOnly15237" style="height:20px;width:150px;"><input type="image" name="wfTextBoxOnly15237imgbtn" id="wfTextBoxOnly15237imgbtn" title="Select Date" src="../../App_Themes/images/date.gif" style="border-width:0px;"><span id="wfTextBoxOnly15237rfv" style="color:Red;display:none;"></span><span id="wfTextBoxOnly15237dv" style="color:Red;display:none;"></span></td></tr></table></td><td></td><td></td></tr><tr><td></td><td></td><td></td><td></td><td colspan="2"><table cellpadding="0" class="content_table" cellspacing="1" border="0"><tr><td><h5 align="center">Attached excel sheet contains list of items with details</h5>
<font color="#41709d" face="SegoeUI-Bold" size="1"><font color="#41709d" face="SegoeUI-Bold" size="1"><font color="#41709d" face="SegoeUI-Bold" size="1"></font></font></font>
 </td></tr></table></td><td></td><td></td></tr><tr><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr></table>
                    
                
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     <p><span id="lblFormVersion" style="color:Red;font-weight:bold;"></span></p>
    

<div>

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	<input type="hidden" name="__SCROLLPOSITIONY" id="__SCROLLPOSITIONY" value="0">
</div>


</form>