New Visit

patient

Patient Name:

Phone number:

PD of patient:

visits:

Date of visit:: 1/3/2025 3:49:00 PM
Cost:: 1800000
Service:: Change Lenses
prescribed by doctor:: Nancy
Notes:: Oldframe+AR

	SPH	CYL	AX	ADD
OD	3
OS	3

New visit Information

Date of visit:

Cost in this visit:

type of service:

prescribed by doctor

Note:

	SPH	CYL	AX	ADD
OD
OS