New Visit

patient

Patient Name:

Phone number:

PD of patient:

visits:

Date of visit:: 5/4/2024 2:06:00 PM
Cost:: 30
Service:: Frame + Lenses
prescribed by doctor:: Luna
Notes:: AR Lenses + Metal

	SPH	CYL	AX	ADD
OD	0	-0.25	130
OS	0.25

New visit Information

Date of visit:

Cost in this visit:

type of service:

prescribed by doctor

Note:

	SPH	CYL	AX	ADD
OD
OS