New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
8/22/2024 11:21:00 AM
Cost:
90
Service:
Lenses only infinity FMC
prescribed by doctor:
Aya
Notes:
SPH
CYL
AX
ADD
OD
0.5
-0.5
90
1.5
OS
0.75
-0.75
90
1.5
New visit Information
Date of visit:
Cost in this visit:
type of service:
prescribed by doctor
Note:
SPH
CYL
AX
ADD
OD
OS
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