New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
6/13/2025 12:09:00 PM
Cost:
120
Service:
prescribed by doctor:
Nancy
Notes:
emporio , AR transition w9
SPH
CYL
AX
ADD
OD
-0.75
-0.25
180
OS
-0.75
-0.25
135
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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