Monday, June 14

ORDER FORMAT

- Name :
- Address : 
- Contact No :
- Email :
- Delivery Method : ( By Post / Self Pick Up )

- GEO LENS CODE & POWER DEGREE :-

1. Code : 
Power Degree :- 
Left / Right 

2. Code : 
Power Degree :-
Left / Right 

3. Code :
Power Degree :-
Left / Right 

- Total Pairs of Order :
- Total Ringgit :

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