New Visit

patient

Patient Name:

Phone number:

PD of patient:

visits:

Date of visit:: 3/28/2024 10:26:00 AM
Cost:: 65
Service:: Frame + Lenses
prescribed by doctor:: Luna
Notes:: Frame + Transition AR

	SPH	CYL	AX	ADD
OD		-0.25	130
OS		-0.25	180

New visit Information

Date of visit:

Cost in this visit:

type of service:

prescribed by doctor

Note:

	SPH	CYL	AX	ADD
OD
OS