Eye Test Prescription
Customer Name
Eye Test Date Friday , 5 Sep 2025
Sumit Store Address RN-11, Ground Floor, Sector -62, Noida,
Uttar Pradesh 201309.
Single Vision Power
Rx Spherical Cylindrical Axis Pupil Distance Add. Power
Right Eye -0.25 0.00 0.00 31 --
Left Eye -0.25 0.00 0.00 31 --
Contact Lens Power
Rx Spherical Cylindrical Axis Pupil Distance Add. Power
Right Eye -0.25 0.00 0.00 -- --
Left Eye -0.25 0.00 0.00 -- --
Your next eye test date
Mar 5
Thursday • 2026
Note: This is a system-generated prescription.