New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
4/8/2024 2:15:00 PM
Cost:
50
Service:
Change Lenses
prescribed by doctor:
Old RX
Notes:
AR Lenses 60 mm
SPH
CYL
AX
ADD
OD
5
OS
4.75
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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