Fresh Lettuce Order Form

Rumah Charis

Lot 10064, Jalan Awan Pintal, Taman Yarl, 58200 Kuala Lumpur, Wilayah Persekutuan Kuala Lumpur

RM10 per lettuce + RM5 delivery (within Klang Valley)

Name: Phone Number: Address: Quantity of Lettuce: Collection Method:

Self Pickup Delivery

Scan QR to Pay

OR Bank Transfer to:

Rumah Charis CH

Affin Bank: 100330009024

Public Bank: 3064040433

⚠️ Please calculate the amount manually (RM10 x quantity + RM5 if delivery). Upload the receipt below.

Upload Payment Receipt: Submit Order

If you encounter any issues, please contact Alison at +60 12-608 9216