New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
8/28/2025 5:18:00 PM
Cost:
60
Service:
Frame + Lenses
prescribed by doctor:
Old RX
Notes:
AR Lenses compacted
SPH
CYL
AX
ADD
OD
3.25
-0.75
170
OS
4.25
-0.75
175
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