New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
7/14/2025 12:15:00 PM
Cost:
25
Service:
Change Lenses
prescribed by doctor:
Old RX
Notes:
AR Lenses
SPH
CYL
AX
ADD
OD
3.75
-2.25
85
OS
2.75
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