[[[["field39","equal_to","YA"]],[["show_fields","field41,field42,field44"],["set_value",null,"1",null,"field44"]],"or"],[[["field57","contains"]],[["show_fields","field58,field61"]],"and"]]
1
Data Pemesan
Nama Pemesanyour full name
Alamat Lengkap Pemesanmore details
0 / 300
Kecamatanyour full name
Kotayour full name
Teleponyour full name
HPyour full name
Data Peserta Aqiqah
Nama Peserta Aqiqahyour full name
Tempatyour full name
Tanggal Lahirof appointment
Jenis kelaminpick one!
Nama Ayahyour full name
Nama Ibuyour full name
Lahir di (Nama RSB/Bidan)your full name
Pilih Tipe Hewan Aqiqah
Qtyyour full name

Rp [field33*field68]

Qtyyour full name

Rp [field70*field66]

Qtyyour full name

Rp [field67*field71]

Pilih Tipe Hewan Aqiqah
Qtyyour full name

Rp [field41*field44]

Estimasi Total yang harus dibayar:

Rp [(field41*field44)+(field33*field68)+(field70*field66)+(field71*field67)]

Alamat pengiriman dan distribusi
No. Telepon Penerimayour full name
Tanggal Diterimaof appointment
Jam Diterimaof appointment
Alamat pengirimanmore details
0 /
Keterangan tambahanmore details
0 /
Persetujuanpick one!
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