New Visit

patient

Patient Name:

Phone number:

PD of patient:

visits:

Date of visit:: 3/24/2024 9:26:00 AM
Cost:: 85
Service:: Frame + Lenses
prescribed by doctor:: Old RX
Notes:: AR Lenses "Kawthrani"

	SPH	CYL	AX	ADD
OD	-2.5	-5	180
OS	-4	-5.5	180

New visit Information

Date of visit:

Cost in this visit:

type of service:

prescribed by doctor

Note:

	SPH	CYL	AX	ADD
OD
OS