New Visit

patient

Patient Name:

Phone number:

PD of patient:

visits:

Date of visit:: 7/25/2024 4:30:00 PM
Cost:: 70
Service:: Freshlook PureHazel
prescribed by doctor:: Aya
Notes:: with degrees

	SPH	CYL	AX	ADD
OD	-1.25
OS	-1.75

Date of visit:: 12/19/2024 1:39:00 PM
Cost:: 40
Service:: Frame+Lenses
prescribed by doctor:: Luna
Notes:: Luna added -0.25 shift from RX to CL (Chloe Frame Nylor)

	SPH	CYL	AX	ADD
OD	-1.5
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