H|2|LUXE OPTICAL INC.|50|SM PAMPANGA|01|00500000008642|ANCEL GRACE FUERZA|PERILLO, JORMANE GESA|5000.00|5000.00|0|0|0.00|0.00|0.00|0.00|0.00|0.00|0.00|5000.00|0.00|03/15/2022|17:55:36|ANCEL GRACE FUERZA|0.00||5059|03/15/2022|17:47:54|03/15/2022|17:49:44
D|2|LUXE OPTICAL INC.|50|SM PAMPANGA|1|LENSREP|LENSREP|LENS REPLACEMENT|0.00|0.00|1.00|0.00|0.00|0.00|OTHERS|LENS REPLACEMENT|LENS REPLACEMENT|0|--|2990.00|LENS REPLACEMENT|NONE|NONE|
D|2|LUXE OPTICAL INC.|50|SM PAMPANGA|1|11672020402101|11672020402101|67ASK3ETC S:-5.25 C:-0.25|0.00|2500.00|2.00|5000.00|5000.00|0.00|LENS|ASPHERIC LENS|SV BSL|0|HKO FSV 1.67 UV420|2500.00|SINGLE VISION|NONE|1.67|
DEFERRED||1108|08/2024|BDO-VISA|5000.00|3|408482
READING|0500004893|PERILLO, JORMANE GESA||RX PRESCRIBED|INGRID VALERIE CRUZ|RIGHT|31|-5.25|-0.25|175|||FAR||||||||||||||
READING|0500004893|PERILLO, JORMANE GESA||RX PRESCRIBED|INGRID VALERIE CRUZ|LEFT|31|-5.25|-0.25|180|||FAR||||||||||||||