New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
4/1/2024 2:05:00 PM
Cost:
100
Service:
2 Frame +2 Lenses
prescribed by doctor:
Aya
Notes:
One For Distance and One for Far (60mm)
SPH
CYL
AX
ADD
OD
2
2.75
OS
1.5
2.75
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