New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
4/17/2025 12:59:00 PM
Cost:
60
Service:
Frame + Lenses
prescribed by doctor:
OLD RX
Notes:
AR
SPH
CYL
AX
ADD
OD
-3.5
-1
170
OS
-2
1.5
180
New visit Information
Date of visit:
Cost in this visit:
type of service:
prescribed by doctor
Note:
SPH
CYL
AX
ADD
OD
OS
Back to List