New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
8/7/2024 11:29:00 AM
Cost:
40
Service:
Change lenses Transtion
prescribed by doctor:
OLD RX
Notes:
SPH
CYL
AX
ADD
OD
1.25
1
175
OS
0.75
1.25
5
New visit Information
Date of visit:
Cost in this visit:
type of service:
prescribed by doctor
Note:
SPH
CYL
AX
ADD
OD
OS
Back to List