New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
7/22/2024 6:54:00 PM
Cost:
140
Service:
Frame + Lenses
prescribed by doctor:
Aya
Notes:
FREEFORM + AR + FRAME
SPH
CYL
AX
ADD
OD
1.5
2
OS
1.5
2
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