New Visit

patient

Patient Name:

Phone number:

PD of patient:

visits:

Date of visit:: 1/10/2024 11:37:00 AM
Cost:: 45
Service:: Frame + Lenses
prescribed by doctor:: Nada ( Renovation)
Notes:: Vertice+AR Lenses

	SPH	CYL	AX	ADD
OD	-3	-0.5	170
OS	-3	-0.75	5

New visit Information

Date of visit:

Cost in this visit:

type of service:

prescribed by doctor

Note:

	SPH	CYL	AX	ADD
OD
OS