New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
5/22/2025 10:49:00 AM
Cost:
60
Service:
Frame + Lenses
prescribed by doctor:
Old RX
Notes:
AR Lenses
SPH
CYL
AX
ADD
OD
-0.75
-1.5
180
OS
-0.25
-1.25
3
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