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BAHT                                                                                  

from __                                ___ to:                                             

Cardholder's Name :                                                                      (as it appears on card)

Guest's Name :                                                                             (if different from above)

Card Number :                                                                                     

Master/VISA Card - the last 3 digits show on the back of the card :                 

AMEX - 4 digits code :                         Expiry date :                                

Card company :                                        Country:                                    

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