New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
2/8/2025 1:52:00 PM
Cost:
200
Service:
Frame + Lenses
prescribed by doctor:
Nancy
Notes:
Metal Frame + PROGRESSIVE Infinity + AR + Transition montage IDOL
SPH
CYL
AX
ADD
OD
2
-0.5
70
2
OS
2
-0.75
75
2
Date of visit:
4/6/2025 3:37:00 PM
Cost:
180
Service:
Frame+Lenses
prescribed by doctor:
Nancy
Notes:
Gucci frame + infinity + AR TRANS (IDOL MONTAGE)
SPH
CYL
AX
ADD
OD
2
-0.5
70
2
OS
2
-0.75
75
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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