New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
8/30/2024 7:12:00 PM
Cost:
80
Service:
Frame + Lenses
prescribed by doctor:
Aya
Notes:
Transition AR
SPH
CYL
AX
ADD
OD
-1.5
-1
10
OS
-1.5
-1
170
Date of visit:
2/18/2025 4:01:00 PM
Cost:
11
Service:
Contact lenses
prescribed by doctor:
Nancy
Notes:
Clear 55
SPH
CYL
AX
ADD
OD
-2
OS
-2
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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