Nome:______________________________Tel.:_______________________Nome:______________________________Tel.

:_______________________

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Pedido: Pedido:

Valor:_____________________ Forma de pagamento: Valor:_____________________ Forma de pagamento:

Nome:______________________________Tel.:_______________________Nome:______________________________Tel.:_______________________

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Pedido: Pedido:
Valor:_____________________ Forma de pagamento: Valor:_____________________ Forma de pagamento: