New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
6/24/2025 11:11:00 AM
Cost:
130
Service:
Frame + Lenses
prescribed by doctor:
Nancy
Notes:
gucci, progressive infinity +montage
SPH
CYL
AX
ADD
OD
0
-0.5
125
2.25
OS
0
-0.75
65
2.25
New visit Information
Date of visit:
Cost in this visit:
type of service:
prescribed by doctor
Note:
SPH
CYL
AX
ADD
OD
OS
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