New Visit

patient

Patient Name:

Phone number:

PD of patient:

visits:

Date of visit:: 8/14/2024 12:22:00 PM
Cost:: 80
Service:: Airlite + lenses Ar 60mm
prescribed by doctor:: Dr. Mohammad Al Haj ali
Notes:

	SPH	CYL	AX	ADD
OD	0.5	4.5	90
OS	1	2	85

Date of visit:: 1/9/2025 12:00:00 PM
Cost:: 130
Service:: Frame + Lenses
prescribed by doctor:: DR. Ali Alhaj
Notes:: AR Lenses 60 mm with Gucci frame

	SPH	CYL	AX	ADD
OD	0.5	4.5	90
OS	1	2	85

New visit Information

Date of visit:

Cost in this visit:

type of service:

prescribed by doctor

Note:

	SPH	CYL	AX	ADD
OD
OS