New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
6/3/2024 4:30:00 PM
Cost:
20
Service:
Change lenses AR
prescribed by doctor:
Old Rx
Notes:
AR Lenses for Near
SPH
CYL
AX
ADD
OD
4
0.75
180
OS
6
0.75
140
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