New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
1/25/2025 11:43:00 AM
Cost:
60
Service:
Frame + Lenses
prescribed by doctor:
Nancy
Notes:
AR , TOMFORD FRAME FOR INTERMEDIATE ZONE
SPH
CYL
AX
ADD
OD
0.5
-0.75
95
0.5
OS
0.25
-0.25
100
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
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