New Visit

patient

Patient Name:

Phone number:

PD of patient:

visits:

Date of visit:: 1/22/2024 12:03:00 PM
Cost:: 35
Service:
prescribed by doctor:: Aya
Notes:: AR

	SPH	CYL	AX	ADD
OD	-1
OS	-1	-0.5	175

Date of visit:: 9/2/2024 7:03:00 PM
Cost:: 11
Service:: CLEAR 55
prescribed by doctor:: Old RX
Notes:: Without Solution

	SPH	CYL	AX	ADD
OD	-1.5
OS	-1.5

New visit Information

Date of visit:

Cost in this visit:

type of service:

prescribed by doctor

Note:

	SPH	CYL	AX	ADD
OD
OS