New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
7/29/2024 6:18:00 PM
Cost:
110
Service:
Frame + Lenses New + Change lenses
prescribed by doctor:
Aya
Notes:
Airlite + Anti-Blue --> NEW (Change Lenses Trans ANTIBLUE for old frame)
SPH
CYL
AX
ADD
OD
-1
OS
-1
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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