New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
2/21/2024 11:37:00 AM
Cost:
15
Service:
change lenses for distance ar modern
prescribed by doctor:
old glasses
Notes:
SPH
CYL
AX
ADD
OD
0.75
1.25
175
OS
1.25
1
175
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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