New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
1/3/2026 5:12:00 PM
Cost:
100
Service:
2 Frames + 2 Pairs of Lenses
prescribed by doctor:
Dr. In Germany
Notes:
2 Airlite Frames + 2 Pairs of lenses compact
SPH
CYL
AX
ADD
OD
4.5
-1.75
3
OS
4
-2
177
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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