New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
3/10/2025 2:39:00 PM
Cost:
150
Service:
Frame + Lenses
prescribed by doctor:
Nancy
Notes:
Airlite + Progressive Infinity (Pro + Montage) 72 years old
SPH
CYL
AX
ADD
OD
-3
-1
60
3
OS
-3
-0.5
73
3
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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