PERFECT VISION OPTICAL CENTRE

Dimiliki oleh: Modern GoldviewSdnBhd 1120967

1120967-D
NO 203,, Lot 3751,Parkcity Commerce Square,Phase 3,
Jalan Tun Ahmad Zaidi, 97000, BINTULU SARAWAK.
TEL:086-333762, FAX:086-336762
GST REG NO:000617078784
PRESCRIPTION FORM
MALING LIKONG
016800845
NO: 0000038
DATE:: 20 OCT 2022

PAGE: 1 OF 2

SPH CYL AXIS ADD V/A REMARK

RIGHT -0.50 +1.00

LEFT -0.50 -0.

0.25 20 +1.00

PD MONO R) 32 PD R)24
64

PD L) 32 HEIGHT L)24

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Issued by: SIEW

Sales person: SIEW
PERFECT VISION OPTICAL CENTRE
Dimiliki oleh: Modern GoldviewSdnBhd 1120967
1120967-D
NO 205, Lot 3751,Parkcity Commerce Square,Phase 3,
Jalan Tun Ahmad Zaidi, 97000, BINTULU SARAWAK.
TEL:086-333762, FAX:086-336762
GST REG NO:000617078784

OFFICIAL RECEIPT
MALING LIKONG
016800845 INVNO
NO: MG01-1036934

DATE: 20 OCT 2022

PAGE: 2 OF 2

ITEM DESCRIPTION UOM QTY PRICE/UNIT (RM) PAID AMOUNT (RM)

1. PRESCRIBED SPECTACLE 1 1600 1600

SALES
ES TOTAL: RM1600
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GST SUMMARY PAID AMOUNT(RM) TAX(RM)
SR(0.00%) (1600.00) (0.00)

NOTE: GOODS SOLD ARE NOT REFUNDABLE OR EXCHANGEABLE.

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Authorized Signature Recipient’s chop & Signature
Sign