New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
3/22/2025 12:57:00 PM
Cost:
110
Service:
2Frame +2 Lenses
prescribed by doctor:
Nancy
Notes:
AR Transition W9 (one frame for far and one for near_
SPH
CYL
AX
ADD
OD
0
2.25
OS
0.5
2.25
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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