New Visit

patient

Patient Name:

Phone number:

PD of patient:

visits:

Date of visit:: 1/9/2025 3:38:00 PM
Cost:: 18
Service:: Change Lenses
prescribed by doctor:: Nancy
Notes:: Old frame ,AR Transition

	SPH	CYL	AX	ADD
OD	-3
OS	-2.5	-1	23

Date of visit:: 5/5/2026 12:23:00 PM
Cost:: 25
Service:: Change Lenses
prescribed by doctor:: Nancy
Notes:: AR

	SPH	CYL	AX	ADD
OD	-3
OS	-2.5	-1	23

New visit Information

Date of visit:

Cost in this visit:

type of service:

prescribed by doctor

Note:

	SPH	CYL	AX	ADD
OD
OS