New Visit

patient

Patient Name:

Phone number:

PD of patient:

visits:

Date of visit:: 7/22/2024 7:00:00 PM
Cost:: 70
Service:: Frame + Lenses
prescribed by doctor:: Aya
Notes:: Rayban Frame + Transition W9 + AR

	SPH	CYL	AX	ADD
OD	-2.25
OS	-2

New visit Information

Date of visit:

Cost in this visit:

type of service:

prescribed by doctor

Note:

	SPH	CYL	AX	ADD
OD
OS