New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
4/16/2024 6:07:00 PM
Cost:
15
Service:
LENSES
prescribed by doctor:
Aya
Notes:
Contact Lenses 1 pair Clear 55 + Neo
SPH
CYL
AX
ADD
OD
-1.25
-0.5
140
OS
0
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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