New Visit

patient

Patient Name:

Phone number:

PD of patient:

visits:

Date of visit:: 12/5/2024 6:32:00 PM
Cost:: 45
Service:: Frame + Lenses
prescribed by doctor:: Nancy
Notes:: AR + transition + HIZO Frame

	SPH	CYL	AX	ADD
OD	-0.25
OS	-0.25	-0.25	75

Date of visit:: 12/5/2024 6:33:00 PM
Cost:: 15
Service:: Change Lenses
prescribed by doctor:: Nancy
Notes:: AR Lenses

	SPH	CYL	AX	ADD
OD	0.5
OS	0.5

New visit Information

Date of visit:

Cost in this visit:

type of service:

prescribed by doctor

Note:

	SPH	CYL	AX	ADD
OD
OS