New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
1/22/2025 10:49:00 AM
Cost:
80
Service:
2 frames +for distance AR modern one for reading
prescribed by doctor:
Nancy
Notes:
AR Lenses
SPH
CYL
AX
ADD
OD
2.5
-0.5
85
2
OS
2.25
-0.5
102
2
New visit Information
Date of visit:
Cost in this visit:
type of service:
prescribed by doctor
Note:
SPH
CYL
AX
ADD
OD
OS
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