OEM Logo
[dlr_name]
(Authorised Dealer for [brand_name] Sales, Service and Spares)
TIN No - [dlr_gst]
[dlr_loc] .
Mobile No. - [dlr_phno]

LR No  [lr_no] LR Date  [lr_date]
Transporter's Name  [transporter_name] No of Cases  [noofcases]
[Claim_Details]