New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
3/28/2025 7:04:00 PM
Cost:
80
Service:
Frame + Lenses
prescribed by doctor:
Nancy
Notes:
Frame + AR + TRANSITION W9
SPH
CYL
AX
ADD
OD
-0.75
-2
10
OS
-0.75
-2.5
170
Date of visit:
6/26/2025 7:00:00 PM
Cost:
70
Service:
Frame + Lenses
prescribed by doctor:
OLD RX
Notes:
Airlite Black + AR + W9
SPH
CYL
AX
ADD
OD
-0.75
-2
10
OS
-0.75
-2.5
170
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