New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
7/22/2024 2:30:00 PM
Cost:
0
Service:
Lenses polyvue
prescribed by doctor:
Assaf
Notes:
R: -4.00 L: -3.75
SPH
CYL
AX
ADD
OD
-3.75
-0.5
170
OS
-3
-1.25
10
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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