New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
5/27/2024 2:12:00 PM
Cost:
35
Service:
Frame + Lenses
prescribed by doctor:
Aya
Notes:
AR Lenses
SPH
CYL
AX
ADD
OD
-0.5
-0.5
140
OS
-0.25
-0.5
24
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