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Full Name :
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Email Address:
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Address :
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Contact No:
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Lens code, Power & quantity:
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Alternative Code (Kalau barang yang saya nak xde stock, sila pilih kod ni):
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Payment method:
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Cimb
Maybank
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I will pay latest by (before/ on):
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Note:
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I agree with PINKY STYLES terms&conditions:
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