New Visit

patient

Patient Name:

Phone number:

PD of patient:

visits:

Date of visit:: 10/8/2025 4:41:00 PM
Cost:: 25
Service:: Change Lenses
prescribed by doctor:: nancy
Notes:: AR Lenses

	SPH	CYL	AX	ADD
OD	0.25	-0.25	120
OS	0.25

New visit Information

Date of visit:

Cost in this visit:

type of service:

prescribed by doctor

Note:

	SPH	CYL	AX	ADD
OD
OS