LENS&FRAME DETAILS

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L SPH CYL AXIS PRISM DIST INT NEAR R SPH CYL AXIS PRISM DIST INT NEAR

Lens Details :
Product Code	Material	Type	Price	VAT%	Quantity

             Frame Details : CLICK HERE     To View Frame Gallery

Product Code	Color	Size	Price	VAT%	Quantity

Customer Name:
Address:
Phone :
e-Mail* :
Remarks*:

The Price of the product is Rs .

Cash       Details:

Cheque/DD Post   Type: Cheque Demand Draft  Type: VPP      Bank:   Amount: No:     Amount:          Date:

 *-- Optional