New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
9/26/2025 3:11:00 PM
Cost:
80
Service:
Frame + Lensea
prescribed by doctor:
Nancy
Notes:
Vivaro Frame + AR 1.61
SPH
CYL
AX
ADD
OD
-4.5
OS
-4.75
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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