Name & Address
C i t y
C o u n t r y
Telephon number / Fax number
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Baby's name &
Birthday |
( Baby's name and birthday are engraved on wooden shaft. ) |
Order
Plaese insert
a cross ( x ) in a box |
□ Fuku mark（$190）
Bamboo shaft ,the both ends of shaft are made with ivory.
In the paulownia box with charm of shrine
Roku mark（$140）
Bamboo shaft coated with paint.
In the paulownia box with charm of shrine
□Boys model / coated with black paint.($140)
□Girls model / coated with orange color paint.($140)
□ Kotobuki mark（$90）
Bamboo shaft. In the paulownia box with charm of shrine |
| reference column |
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Total the amount of money $
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 Please enclose Baby's hair without forgetting this order sheet and money. |
HIRAO BUNMEIDO
5-7-24 Jonohori Kumano-cho
Aki-gun Hiroshima-Prefecture
731-2415 JAPAN
TEL +81 0828540339
FAX +81 0828550055
URL http://www.hi-bun.jp
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