Online Order Form


Salutation
Name
Company
Shipping Address
Postal Code
Country
Contact Number
Fax Number
E-mail
SPH - Left Eye
SPH - Right Eye
CYL - Left Eye
CYL - Right Eye
AXIS - Left Eye
AXIS - Right Eye
ADD - Left Eye
ADD - Right Eye
Purpose of Glasses Distance or Reading
Pupilary Distance mm
Frame Model
Frame Color
Frame Size
Refractive Index 1.56 Clear
  1.56 MAR Coating
  1.61 MAR Coating
  1.67 MAR Coating
  1.74 MAR Coating
Remarks, if any

  


or alternatively, you can click here to download the order form, fill it up and email it back to us for our processing.

 

Thank You, that’s our first step
………towards perfecting vision !!!!!