New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
1/26/2026 11:18:00 AM
Cost:
12
Service:
Contact Lenses clear 55
prescribed by doctor:
nancy
Notes:
clear 55
SPH
CYL
AX
ADD
OD
-3
OS
-1
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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