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Order form
Note:
1- Please fill up all items and you will get customer ID for the next use via email.
2- Please insert "N/A" for any item, if it's not applicable for you.
Personal information
Customer Id
Full Name*
Company / Office*
Email*
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Address*
Description
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Order Detail
Product
Choose Product
Cristalens>>Lucis
Cristalens>>Clare
Cristalens>>Cristal
Omni>>Innova-Asp
Omni>>GenNext
Omni>>Acquafold
Omni-PMMA>>AC
Omni-PMMA>>PC
ATP Hydrophilic>>Amitist
ATP Hydrophilic>>Antique
ATP Hydrophobic>>Ruby
ATP Hydrophobic>>Diamond
ATP-Blade>>3.2mm
ATP-Blade>>2.8mm
ATP-Blade>>2.5mm
ATP-Blade>>1.8mm
ATP-Blade>>Cresent
ATP-Blade>>MVR
ATP-Blade>>15D
Surgistar>>3.2mm
Surgistar>>2.8mm
Surgistar>>2.5mm
Surgistar>>1.8mm
Surgistar>>2.2mm
Surgistar>>Cresent
Surgistar>>MVR
Surgistar>>15D
ATP-visc>>2%-2ml
UVGEL>>2%-2ml
Cristavisc>>1ml
LALABS>>LALOAN
LALABS>>LAGEL
ATP>>2.8mm
ATP>>2.5mm
ATP>>2.2mm
ATP>>1.8mm
Omni>>2.8mm
Omni>>2.5mm
ATP>>10-11mm
ATP>>12-13mm
ATP-Iris>>-
Omni>>-
ATP-Blue>>vial
ATP-Blue>>Syringe
ATP-Blue>>Ampol
ATP-Chol>>Vial
ATP-Chol>>Syringe
ATP-Chol>>Ampol
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Operation
You must select at least 1 product for order