Order Form

Name:
Email Address:
Phone No.
Address
Lens Type/Series
Degree(Right)
Degree(Left)
Please state the additional order here
Comments
Shipment	Pos Ekpress                 Pos Laju                 International Mail
Type of Payment	Maybank                 Cimb                 Paypal

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Beuberry Velvet

VELVET GREY:0-750
VELVET BROWN:0-750