New Visit

patient

Patient Name:

Phone number:

PD of patient:

visits:

Date of visit:: 7/31/2025 12:49:00 PM
Cost:: 50
Service:: Frame + Lenses
prescribed by doctor:: luna
Notes:: AR

	SPH	CYL	AX	ADD
OD	-1	-0.25	165
OS	-1.25	-0.25	177

New visit Information

Date of visit:

Cost in this visit:

type of service:

prescribed by doctor

Note:

	SPH	CYL	AX	ADD
OD
OS