New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
5/6/2024 6:40:00 PM
Cost:
150
Service:
Frame + Lenses
prescribed by doctor:
Aya
Notes:
Infinity FMC Transition
SPH
CYL
AX
ADD
OD
2.5
-1
90
2
OS
2.5
-0.75
90
2
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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