New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
6/19/2024 2:39:00 PM
Cost:
15
Service:
Change lenses AR
prescribed by doctor:
Aya
Notes:
For Near ONLY
SPH
CYL
AX
ADD
OD
0.75
2.5
OS
0.75
2.5
Date of visit:
3/11/2025 1:08:00 PM
Cost:
40
Service:
Frame+Lenses
prescribed by doctor:
Nancy
Notes:
AR, airlite
SPH
CYL
AX
ADD
OD
3.5
-0.75
105
OS
3
New visit Information
Date of visit:
Cost in this visit:
type of service:
prescribed by doctor
Note:
SPH
CYL
AX
ADD
OD
OS
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