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Pin Code

Customer Name

Mobile Number

Alternate Mobile Number

Email ID

State Office

Hub

Monthly Fuel Requirement in Litres

Range between 1 to 5000000 allowed.

No. of Vehicles

Range between 1 to 500 allowed.

Major Route

Present Supplier

Multiple selections are allowed using Ctrl Key

Present Supplier Details

0/500

Description

0/1000

Select file

File should be jpg, jpeg, pdf, xls, xlsx, doc, docx format and size should not exceed 5Mb.

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