New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
5/10/2024 6:59:00 PM
Cost:
20
Service:
Frame + Lenses
prescribed by doctor:
Old Rx
Notes:
Metal + Pro
SPH
CYL
AX
ADD
OD
2
0.5
170
OS
2.25
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