New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
1/22/2026 5:59:00 PM
Cost:
120
Service:
Frame + Lenses
prescribed by doctor:
dr. Sabrina rammal
Notes:
Transition AR w9
SPH
CYL
AX
ADD
OD
2.25
-0.75
80
OS
-0.5
-0.25
160
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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