New Visit

patient

Patient Name:

Phone number:

PD of patient:

visits:

Date of visit:: 8/8/2024 5:27:00 PM
Cost:: 50
Service:: Frame + Lenses
prescribed by doctor:: Aya
Notes:: Airlite + AR Lenses Transtion

	SPH	CYL	AX	ADD
OD	-1.5
OS	-1.5

Date of visit:: 5/9/2025 5:41:00 PM
Cost:: 30
Service:: Change Lenses
prescribed by doctor:: Dr. In mawada
Notes:: AR Lenses

	SPH	CYL	AX	ADD
OD	-2	-0.25	105
OS	-1.5

New visit Information

Date of visit:

Cost in this visit:

type of service:

prescribed by doctor

Note:

	SPH	CYL	AX	ADD
OD
OS