New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
3/14/2024 11:59:00 AM
Cost:
80
Service:
Frame + Lenses
prescribed by doctor:
Dr. Sabrina Rammal
Notes:
Metal Frame + AR Lenses + Compact
SPH
CYL
AX
ADD
OD
3.25
-1.75
175
OS
6.5
-3
20
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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