New Visit

patient

Patient Name:

Phone number:

PD of patient:

visits:

Date of visit:: 2/28/2024 9:38:00 AM
Cost:: 0
Service:: lenses
prescribed by doctor:: old glasses
Notes:

	SPH	CYL	AX	ADD
OD	-1.25	-0.25	120
OS	-0.75	-0.5	30

Date of visit:: 2/29/2024 4:38:00 PM
Cost:: 14
Service:: Contact Lenses
prescribed by doctor:: FROM RX
Notes:: Took NEO Plus too

	SPH	CYL	AX	ADD
OD	-1.5
OS	-1

Date of visit:: 9/11/2024 4:24:00 PM
Cost:: 11
Service:: Contact Lenses
prescribed by doctor:: Old RX
Notes:

	SPH	CYL	AX	ADD
OD	-1.5
OS	-1

Date of visit:: 9/11/2024 4:24:00 PM
Cost:: 11
Service:: Contact Lenses
prescribed by doctor:: Old RX
Notes:

	SPH	CYL	AX	ADD
OD	-1.5
OS	-1

New visit Information

Date of visit:

Cost in this visit:

type of service:

prescribed by doctor

Note:

	SPH	CYL	AX	ADD
OD
OS