New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
4/18/2025 11:52:00 AM
Cost:
60
Service:
Frame + Lenses
prescribed by doctor:
Nancy+ old rx
Notes:
Guess frame, AR 1.61
SPH
CYL
AX
ADD
OD
-3.75
-1
180
OS
-2.5
-0.5
180
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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