Form Delivery Order

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                                               TM                                                                                            Tel: 03-7728 2288
Quality Nyonya Kueh and Delights                                                                                                                  012-515 8822
                                                              ORDER FORM (v.5.1)                                                             Fax: 03-7710 1263
● Delivery hours - 9 am to 6 pm.
● Order is only valid when we have confirmed it with you. If you have not received confirmation, please contact us to enquire.
● Minimum order is RM80 for free delivery.
● Please give us at least 24 hours notice to deliver your order. For shorter notice, please call to check if delivery is possible.
● Delivery service is available only for certain locations in PJ and central KL. For delivery enquiry, please call 012-373 1960
Type in your order quantity in blue boxes (total count and value will be generated automatically) and delivery details in green boxes.
                                                     Price    Qty        Total                                                               Price     Qty           Total
                                                      (RM)                (RM)                                                                (RM)                      (RM)

Kueh                                                                                Savoury
Bingka Beras                                          0.90                          Chicken Curry Puff                                        1.30
Bingka Ubi                                            0.90                          Chicken Samosa                                            1.00
Egg Sponge Cake                                       1.30                          Cokodok (per stick of 3 pcs.)                             1.20
Getuk Getuk                                           0.90                          Cucuk Udang (3 pcs)                                       2.00
Ketayap                                               0.90                          Fried Spring Roll                                         1.00
Kochi Nyonya                                          0.90                          Koswee Masin                                              0.60
Kochi Santan                                          1.00                          Otak Otak                                                 2.20
Koswee Gula Melaka                                    0.70                          Pulut Panggang                                            1.00
Koswee Pandan                                         0.70                          Pulut Sambal                                              1.20
Lapis Beras                                           0.90                          Radish Cake (Lo Pak Ko)                                   1.30
Lapis Pandan                                          0.90                          Yam Cake                                                  2.00
Lapis Selatan                                         0.90                          Thai Mee Hoon                                             2.50
Lipat Pisang                                          0.90                          Nasi Lemak Pandan                                         2.50
Mini Ang Ku (Classic)-Mung Bean fill                  0.70                          Meals
Mini Pandan Ku -Mung Bean fill                        0.70                          Chicken & Century Egg Porridge                            3.80
Mini Pandan Ku-G.Melaka Coconut fill                  0.70                          Nasi Kunyit with Curry Chicken                            8.90
Mini Sesame Seed Ku - Peanut fill                     0.80                          Nasi Lmk. Pandan+Rendang Chicken                          8.90
Ondeh Ondeh (6 pcs)                                   1.80                          Thai Mee Siam with Honey Chicken                          8.90
Pulut Inti                                            1.00                          Nasi Briyani (Chicken or Mutton) Min 20                   12.90
Pulut Tai Tai (with Kaya)                             1.00                          Sandwiches
Putri Ayu                                             0.65                          Tuna Sandwich                                             3.80
Red Bean                                              0.90                          Cheddar Cheese                                            3.80
Sago Ubi                                              0.90                          Egg Sandwich                                              3.50
Seri Muka                                             0.90                          Chicken Sandwich                                          3.80
Steamed Tapioca with Banana                           0.90                          Hot Dessert
Steamed Tapioca with Coconut                          0.90                          Bubur Cha Cha (Fri & weekend only)                        3.80
Sweet Potato ("3 Sisters")                            0.90                          Red Bean                                                  3.50
Talam                                                 0.90                          Hak Lo Mai (Black Glutinous Rice)                         3.50
Talam Keladi (Yam)                                    0.90                          Mak Chuk (Wheat)                                          3.50
Talam Nyonya                                          0.90                          Longan and Sea Coconut                                    3.50
Talam Ubi                                             0.90                          Green Bean                                                3.50

Total quantity count
Packaging (please enquire if you require special packaging)    RM
Total order value                                              RM                   payable in cash upon delivery

When do you need it?                                                                Other business terms and conditions
Time:                                                                               ● Actual product appearance may vary from that shown in the Menu.
Date:                                                         Day:                  ● All products shown are subject to availability.
Pls fill details for delivery:                                                      ● We take no responsibility over late delivery due to reasons beyond our control.
Name:                                                                               ● We reserve the right to decline the orders received.
Contact tel. no. :                                                   (min.2 nos.)   ● Cancellation of order will not be accepted once we have confirmed it with you.
Company name:                                                                       ● Prices are subject to change unless customer order has been confirmed by us.
                                                                                    ● We reserve the right to amend all terms and conditions without prior notice.
Address :

Useful landmarks:
                                                                     5:17 PM4/20/2011                  82c2e69f-234c-456f-a6ec-67c65682f5b3.xls

Description: Form Delivery Order document sample