New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
5/1/2024 1:23:00 PM
Cost:
75
Service:
Frame + Lenses
prescribed by doctor:
Dr. Sabrina Rammal
Notes:
AR + Compact
SPH
CYL
AX
ADD
OD
5.25
-0.5
180
OS
5.5
-0.5
10
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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