You should probably have something more like this.
Patient(Patient_ID(PK), name, surname)
Visit(Patient_id(PK, FK), start_time(PK), description)
The visit id number serves no useful purpose from the database design point of view. Instead, it increases the likelihood of duplicate data. For example, this
Visit(Visit_ID(PK), Patient_id(PK), date, description)
would allow rows that look like this.
visit_id patient_id date description -- 1 1 2014-05-09 Office visit 2 1 2014-05-09 Office visit 3 1 2014-05-09 Office visit 4 1 2014-05-09 Office visit
(Both structures you posted have the same problem.)