New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
4/8/2025 1:08:00 PM
Cost:
135
Service:
Frame + Lenses
prescribed by doctor:
Dr. Carole Cherfan
Notes:
Airlite + Executaive Lenses Montage IDOL (The mother and aunt took two sunglasses)
SPH
CYL
AX
ADD
OD
4
0.75
90
2
OS
4
0.75
90
2
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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