Name: Coupon 2
SKU: 887
Availability: InStock

Coupon 2

$75.00

In addition to BACKUP SANTE card, this booklet of coupons allows the beneficiary to cover any paid service available in DASH’s network in case needed (pharmacy, labs… )

* To be used ONLY on the network of DASH.
* Each coupon has a value of 150 HTG.

* The coupons are NON REFUNDABLE and NON EXCHANGEABLE.

Product Name

Number of beneficiaries(Required)

First beneficiary

Name(Required)

First Last

Phone(Required)

Home Address or approximately(Required)

Street Address City Country

Second beneficiary

Name(Required)

First Last

Phone(Required)

Home Address or approximately(Required)

Street Address City Country

Third beneficiary

Name(Required)

First Last

Phone(Required)

Home Address or approximately(Required)

Street Address City Country

Fourth beneficiary

Name(Required)

First Last

Phone(Required)

Home Address or approximately(Required)

Street Address City Country

Total

Agent

Name(Required)

First Last

Code

Dash International

Coupon 2

First beneficiary

Second beneficiary

Third beneficiary

Fourth beneficiary

Total

Dash International

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