New Visit

patient

Patient Name:

Phone number:

PD of patient:

visits:

Date of visit:: 3/13/2025 2:44:00 PM
Cost:: 80
Service:: Frame+lenses
prescribed by doctor:: Nancy
Notes:: AR Transition W9+change lenses of an old frame

	SPH	CYL	AX	ADD
OD	-0.25	-1	100
OS	-0.5	-0.75	50

New visit Information

Date of visit:

Cost in this visit:

type of service:

prescribed by doctor

Note:

	SPH	CYL	AX	ADD
OD
OS