user
wes
2006-07-09T07:03:48Z
2006-07-09T05:31:57Z
2006-07-09T07:04:40Z
11.5606
6150
7515
360
105
False
False
| 1003-1005 Victoria Road |
| West Ryde NSW 2114 |
Holding Period |
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| Tel: (02)9809 4296 |
1 day 2 days 3 days _days |
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| Fax: (02)9809 3587 |
| Express Eyecare Order Form |
Job No.___________ |
| From: |
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Ref: |
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Date: |
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| Lens Type: |
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Rx |
Sphere |
Cylinger |
Axis |
Addition |
Prism |
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Right |
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Col. |
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Left |
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% |
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| Fram Type: |
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Right |
Left |
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Coating |
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D.PD |
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Muticoat |
Hardcoat |
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N.PD |
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Height |
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Others: |
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Width |
Bridge |
Depth |
Diagonal |
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| R/S: |
1st L R F |
2nd L R F |
3rd L R F |
_th L R F |
Reason: |
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Checker: |
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Sender: |
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Send Date: |
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| Specialist: |
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9
-3
-3
3
R1C1:R24C11
False
False
False
False
False
False