New Visit

patient

Patient Name:

Phone number:

PD of patient:

visits:

Date of visit:: 5/12/2025 11:46:00 AM
Cost:: 5
Service:: refraction
prescribed by doctor:: nancy
Notes:: AR

	SPH	CYL	AX	ADD
OD	-0.25	-0.25	100
OS	-0.5

New visit Information

Date of visit:

Cost in this visit:

type of service:

prescribed by doctor

Note:

	SPH	CYL	AX	ADD
OD
OS