Services and Materials at a reasonable cost

1.	On the ………………….. day of ………….. 20…….. at ………..…….. the plaintiff built a house [known as No. ……………….. in], and furnished the materials therefor, for the defendant, at his request, but no express agreement was made as to the amount to be paid for such work and materials.

2.	The word done and materials supplied were reasonably worth …………… rupees.

3.	The defendant has not paid the money.