New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
5/3/2024 5:02:00 PM
Cost:
60
Service:
Frame + Lenses
prescribed by doctor:
Old Rx
Notes:
Airlite + AR Lenses + 60mm
SPH
CYL
AX
ADD
OD
2
OS
3
-1
170
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