New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
2/17/2024 10:23:00 AM
Cost:
60
Service:
frame + lenses 1.67 AR
prescribed by doctor:
Aya
Notes:
Dior frame + lenses
SPH
CYL
AX
ADD
OD
-5.25
-1.25
17
OS
-6
-0.75
150
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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