New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
6/3/2025 10:56:00 AM
Cost:
50
Service:
Change Lenses
prescribed by doctor:
Old RX
Notes:
antiblue 1.61
SPH
CYL
AX
ADD
OD
-4.5
OS
-3
-1
15
New visit Information
Date of visit:
Cost in this visit:
type of service:
prescribed by doctor
Note:
SPH
CYL
AX
ADD
OD
OS
Back to List