New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
10/17/2025 1:30:00 PM
Cost:
220
Service:
Frame + Lenses
prescribed by doctor:
luna
Notes:
prog AR+Transition
SPH
CYL
AX
ADD
OD
0.5
-2
90
2.5
OS
0.25
-1.75
80
2.5
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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