New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
2/5/2025 12:46:00 PM
Cost:
50
Service:
Frame + Lenses
prescribed by doctor:
Dr. Sabrina Rammal
Notes:
Olive People + AR
SPH
CYL
AX
ADD
OD
-1.5
-0.5
95
OS
-1
-0.5
65
Date of visit:
2/5/2026 2:20:00 PM
Cost:
60
Service:
Frame+Lenses
prescribed by doctor:
OLD Rx
Notes:
Dr. Sabrina Rammal
SPH
CYL
AX
ADD
OD
-1.25
-1.25
95
OS
-0.75
-1
75
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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