Name:
E-mail:
Contact number:
Fax:
Fax:
Address:
item Type:
Item Name:
Quantity:
Price:
Total Price:
EXAMPLE.
Name: XXX
E-mail: xxx@hotmail.com
Contact number: xxx-xxxxxxx
Fax: xx-xxxxxxxx
Fax: xx-xxxxxxxx
Address: xxxxxxx
Item Type: Lens
Item Name: Geo ( brown)
Cleb Nudy Grey
Lens Power: R150/L200 (GEO)
R175/L175 (CELEB)
Cleb Nudy Grey
Lens Power: R150/L200 (GEO)
R175/L175 (CELEB)
Quantity: 2
Price: RM 30
Total Price: RM 60
