New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
8/28/2025 5:12:00 PM
Cost:
60
Service:
Frame + Lenses
prescribed by doctor:
Dr. Sabrina Rammal
Notes:
AR Lenses
SPH
CYL
AX
ADD
OD
1
OS
2.75
Date of visit:
1/6/2026 3:32:00 PM
Cost:
20
Service:
change lenses
prescribed by doctor:
Dr. Sabrina Rammal
Notes:
AR
SPH
CYL
AX
ADD
OD
1.75
-0.25
145
OS
3.25
-0.25
160
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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