New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
3/11/2025 3:13:00 PM
Cost:
250
Service:
Frame + Lenses
prescribed by doctor:
Dr. Mariam Iskandar
Notes:
Gino's Frame + Infinity + AR + Transition (IDOL)
SPH
CYL
AX
ADD
OD
0
-0.25
95
1.25
OS
0
-0.5
90
1.25
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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