New Visit

patient

Patient Name:

Phone number:

PD of patient:

visits:

Date of visit:: 1/3/2025 4:44:00 PM
Cost:: 60
Service:: Frame + Lenses
prescribed by doctor:: Nancy
Notes:: AR' metallic frame

	SPH	CYL	AX	ADD
OD	-1.25	-0.5	100
OS	-1.5

Date of visit:: 5/16/2026 4:07:00 PM
Cost:: 60
Service:: Frame+Lenses
prescribed by doctor:: Zaynab
Notes:: AR

	SPH	CYL	AX	ADD
OD	-1.75	-0.25	106
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