New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
2/19/2024 12:05:00 PM
Cost:
135
Service:
2 frame +for distance ar modern one for reading
prescribed by doctor:
aya
Notes:
SPH
CYL
AX
ADD
OD
0.75
-0.75
90
2.25
OS
0.75
-1.5
80
2.25
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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