Invoice Details
Invoice Number
Please Enter Invoice Number
Only alphanumeric and space are allowed
Barcode Number
Please Enter Barcode Number
Only alphanumeric and space are allowed
Total
Please Enter Total
Please enter valid amount
Telephone
Please Enter Telephone Number
Only numbers and hyphen are allowed
Email
Invalid Email format.
Name
Please Enter your Name
Only Alphabets Are Allowed
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Payment will be debited on Due Date
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Payment Successful!!
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Payment Successful!!
Payment Details
FRM-017-007-005 REGISTRATION FEE SCHEDULE
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
*
Please Enter Card Number
Only number allowed
Expiry Date
*
Please Enter Expiry Month
Only number allowed
Please Enter Expiry Year
Only number allowed
Card Holder's Name
*
Please Name On Card
Only Alphabets Are Allowed
Card Holder's Address
*
Please Enter Street Number
Please Enter Street Name
Please Enter Postal Code
Invalid Postal Code
CVV
*
Please Enter CVV
Please enter valid CVV
What is CVV?
Payment Plan
Full Payment
NOTE:
Additional admin fee of $30 or $60 will be applicable for 6 months and 12 months payment options respectively.
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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