New Visit

patient

Patient Name:

Phone number:

PD of patient:

visits:

Date of visit:: 2/6/2024 5:44:00 PM
Cost:: 65
Service:: Frame + Lenses
prescribed by doctor:: Aya
Notes:: HUZO FRAME + TRANSITION LENSES AR

	SPH	CYL	AX	ADD
OD	0.75
OS	1

New visit Information

Date of visit:

Cost in this visit:

type of service:

prescribed by doctor

Note:

	SPH	CYL	AX	ADD
OD
OS