New Visit

patient

Patient Name:

Phone number:

PD of patient:

visits:

Date of visit:: 3/18/2024 10:03:00 AM
Cost:: 50
Service:: Change Lenses
prescribed by doctor:: Dr. Sadek Sadek
Notes:: AR Lenses 1.67

	SPH	CYL	AX	ADD
OD	-6
OS	-6

Date of visit:: 2/25/2026 12:03:00 PM
Cost:: 140
Service:: Frame+Lenses
prescribed by doctor:: Nancy
Notes:: AR 1.67

	SPH	CYL	AX	ADD
OD	-6
OS	-6

New visit Information

Date of visit:

Cost in this visit:

type of service:

prescribed by doctor

Note:

	SPH	CYL	AX	ADD
OD
OS