Invoice Details
Invoice Number
Barcode Number
Total
Telephone
Email
Name
×
Payment will be debited on Due Date
×
Payment Successful!!
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Payment Successful!!
Payment Details
FRM-017-007-004 REGISTRATION FEE SCHEDULE.doc
IMPORTANT
If you have ever been diagnosed with HIV (AIDS), Hepatitis B or Hepatitis C; please contact
CReATe Cord Blood Bank
before proceeding with the registration.
Member ID
Order Number
Promotion Code
Total Price
Auth. Code
Transaction Date
Result
Message
Card Number
*
Expiry Date
*
Card Holder's Name
*
Card Holder's Address
*
CVV
*
What is CVV?
Payment Plan
Full Payment
Payment will be charged automatically on the due date you provided in your registration. Installments will be charged each subsequent month according to the payment plan chosen. Please contact the office if you wish to make any changes to this registration.
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