New Visit

patient

Patient Name:

Phone number:

PD of patient:

visits:

Date of visit:: 3/5/2024 11:10:00 AM
Cost:: 5
Service:: Eye exam
prescribed by doctor:: Aya
Notes:

	SPH	CYL	AX	ADD
OD		-0.25	70	2
OS		-0.5	110	2

Date of visit:: 3/8/2024 1:31:00 PM
Cost:: 30
Service:: Reading Frame
prescribed by doctor:: Aya
Notes:: gave back 5$

	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