Prescription card

Example One

Dr John Optical

5005 Westheimer Rd,TX,USA

Patient :

Expiration date :

Prescribed by :

Example Two

5005 Westheimer Rd,TX,USA

Patient :

Expiration date :

Prescribed by :

Example Three

5005 Westheimer Rd,TX,USA

Patient :

Expiration date :

Prescribed by :

Hover your mouse over the prescription to find out what each of the abbreviations and numbers mean.

Enter prescription details

	{{labels.spherical.title}}	{{labels.cylindrical.title}}	{{labels.axis.title}}	{{labels.addition.title}}
{{labels.rightEye.title}}
{{labels.leftEye.title}}
{{labels.prism.title}}
	{{labels.verticalPrism.title}}	{{labels.baseDirection.title}}	{{labels.horizontalPrism.title}}	{{labels.baseDirection.title}}
{{labels.rightEye.title}}
{{labels.leftEye.title}}
{{labels.pupillary.title}}
Check here if you have two PD numbers