New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
6/26/2024 3:30:00 PM
Cost:
90
Service:
Frame + Lenses
prescribed by doctor:
Aya
Notes:
Bifocal + Transition + AR
SPH
CYL
AX
ADD
OD
2
-0.5
80
2.25
OS
2.5
-0.5
100
2.25
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