First name

Last name

Country

Town / City

District

Phone

Email address

Order notes (optional)

Product	Subtotal
Chiq 32 inch Frameless Android Smart TV × 1	UShs 500,000
Samsung 43 inch UHD Crystal 4K Smart TV \| BU8000 × 1	UShs 1,980,000
Samsung 40inch Full HD TV - Black × 1	UShs 1,190,000
Kenwood Rice Cooker with Steamer \| RCM44 × 1	UShs 290,000
Subtotal	UShs 3,960,000
Shipment	Delivery to Kampala: UShs 5,000
Total	UShs 3,965,000