MODEM REQUEST FORM
LCO NAME
NETWORK NAME
TIC ID
MOBILE NUMBER
EMAIL ID
TYPE OF OLT
GPON
EPON
ADDRESS
OUTRIGHT PURCHASE
S.No
DETAILS
PRICE
GST 18%
TOTAL
1
X PON DUAL BAND ONT
1750
315
2065
2
G PON DUAL BAND ONT
1750
315
2065
PRODCT NAME
QTY
AMOUNT
1. X PON DUAL BAND ONT
2. G PON DUAL BAND ONT
TOTAL AMOUNT
