New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
7/24/2024 6:17:00 PM
Cost:
150
Service:
Frame + Lenses
prescribed by doctor:
Aya
Notes:
FREE FORM AR + AIRLITE
SPH
CYL
AX
ADD
OD
2.75
2.5
OS
2.75
2.5
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