New Visit

patient

Patient Name:

Phone number:

PD of patient:

visits:

Date of visit:: 5/16/2025 1:46:00 PM
Cost:: 0
Service:: 2 Frame + 2 Lenses
prescribed by doctor:: Nancy
Notes:: AR Lenses for 1 glasses and AR transition for oliver people glasses

	SPH	CYL	AX	ADD
OD	-2.5	-1.25	17
OS	-1.75	-1.25	166

New visit Information

Date of visit:

Cost in this visit:

type of service:

prescribed by doctor

Note:

	SPH	CYL	AX	ADD
OD
OS