New Visit

patient

Patient Name:

Phone number:

PD of patient:

visits:

Date of visit:: 6/6/2024 3:57:00 PM
Cost:: 70
Service:: Frame + Lenses
prescribed by doctor:: Aya
Notes:: AR Lenses

	SPH	CYL	AX	ADD
OD	-1.75	-0.5	15
OS	-1	-0.75	170

Date of visit:: 6/6/2024 3:58:00 PM
Cost:: 10
Service:: Clear 55
prescribed by doctor:: Aya
Notes:: With Solution (300,000)

	SPH	CYL	AX	ADD
OD	-2
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