New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
6/24/2024 6:44:00 PM
Cost:
80
Service:
Frame + Lenses
prescribed by doctor:
Old RX
Notes:
AR 1.67
SPH
CYL
AX
ADD
OD
-4.5
-1.5
160
OS
-3
-1.5
40
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