New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
5/5/2025 11:35:00 AM
Cost:
0
Service:
Frame + Lenses
prescribed by doctor:
0ld rx
Notes:
flattop idol
SPH
CYL
AX
ADD
OD
7.25
0.25
180
OS
7.5
0.5
10
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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