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Customer Detail

Customer Number

Company name

Company name
(Roman characters)

Contact person

Contact person
(Roman characters)

Gender

Male

Female

Address

E-mail

Phone number

Payment method

Payment on invoice

Deposit

Paypal

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Price setting

JPY

Urgent price setting

Order quantity pricing

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Patient List

Patient Code	Patient Name	Age	Gender
20352321	Mia　Okada	11	Female