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| Card Number: | |
| Expiration Date: | |
| Security Code: | |
| Cardholder Name: |
| Item total: | HKD | 1040.0 |
| Shipment: | HKD | 35.0 |
| Discount: | HKD | -0.0 (0% off) |
| Total price: | HKD | 1075.0 |
