New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
3/21/2024 11:47:00 AM
Cost:
40
Service:
Frame + Lenses
prescribed by doctor:
Old RX
Notes:
Metal + AR Lenses
SPH
CYL
AX
ADD
OD
-0.5
OS
-0.25
-0.25
125
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