The image is a photograph of a receipt from Dennis Hura, dated June 25, 2014. The receipt is printed on a white paper with black text. The title of the receipt is "Dennis Hura" and it is written in bold letters at the top. Below the title, there is a phone number, address, and phone number. 

The receipt also includes a note that reads "OD: 4.50 - 0.25 x 1.01" and "OS: 4,45 - 1,00 x 1,05". The note also mentions that the prescription is for maximum eye protection and is recommended for children aged 4-5 years old.

At the bottom of the note, there are several details about the prescription, including the prescription's name, contact information, and other relevant information. There is also a signature at the bottom right corner that says "Polarized, Polarized, and Spare Pair."

Overall, the receipt appears to be a receipt for a prescription for a pair of sunglasses.