New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
8/12/2025 4:09:00 PM
Cost:
75
Service:
Frame + Lenses
prescribed by doctor:
old rx
Notes:
Antiblue green
SPH
CYL
AX
ADD
OD
-1
-0.5
170
OS
-0.5
-1
3
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