New Visit

patient

Patient Name:

Phone number:

PD of patient:

visits:

Date of visit:: 12/2/2024 10:32:00 AM
Cost:: 40
Service:: Frame+Lenses
prescribed by doctor:: Luna
Notes:: AR

	SPH	CYL	AX	ADD
OD	-1.25
OS	-0.5	-0.25	10

Date of visit:: 1/25/2025 4:36:00 PM
Cost:: 25
Service:: Change lenses
prescribed by doctor:: Dr. Mohamad Abady
Notes:: AR Lenses

	SPH	CYL	AX	ADD
OD	-1
OS		-0.5	180

Date of visit:: 9/26/2025 2:44:00 PM
Cost:: 25
Service:: Change Lenses
prescribed by doctor:: Nancy
Notes:: AR LENSES

	SPH	CYL	AX	ADD
OD	-1.25
OS	0	-0.75	175

New visit Information

Date of visit:

Cost in this visit:

type of service:

prescribed by doctor

Note:

	SPH	CYL	AX	ADD
OD
OS