New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
1/22/2024 3:46:00 PM
Cost:
80
Service:
Chanel Frame + Transition Lenses
prescribed by doctor:
Notes:
OLD degrees
SPH
CYL
AX
ADD
OD
1.75
-50
167
OS
1.75
-0.5
160
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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