New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
5/15/2024 3:08:00 PM
Cost:
50
Service:
Frame + Lenses
prescribed by doctor:
Dr. Jamal Bleik
Notes:
Airlite + AR Lenses
SPH
CYL
AX
ADD
OD
0.75
0.75
90
OS
1
0.5
90
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