New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
4/14/2025 11:30:00 AM
Cost:
50
Service:
2change lenses
prescribed by doctor:
Nancy
Notes:
AR, 2 old frame
SPH
CYL
AX
ADD
OD
1
-1.5
27
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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