New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
12/30/2025 1:30:00 PM
Cost:
65
Service:
Frame + Lenses
prescribed by doctor:
Luna
Notes:
Metal + AR Lenses
SPH
CYL
AX
ADD
OD
-0.75
-0.5
100
OS
-0.25
-0.5
60
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