New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
7/21/2025 11:58:00 AM
Cost:
10
Service:
change 1 left lens
prescribed by doctor:
old rx
Notes:
AR
SPH
CYL
AX
ADD
OD
OS
-2
-2.25
165
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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