New Visit

patient

Patient Name:

Phone number:

PD of patient:

visits:

Date of visit:: 8/13/2024 12:27:00 PM
Cost:: 50
Service:: Metel Frame +AR lenses for distance
prescribed by doctor:: Dr. Ali Hakim
Notes:

	SPH	CYL	AX	ADD
OD	-1	-1	55
OS	-1.75	-0.25	160

Date of visit:: 8/13/2024 12:29:00 PM
Cost:: 15
Service:: change lenses ar
prescribed by doctor:: aya
Notes:

	SPH	CYL	AX	ADD
OD	-1.75	-0.5	50
OS	-2.75	-0.5	160

New visit Information

Date of visit:

Cost in this visit:

type of service:

prescribed by doctor

Note:

	SPH	CYL	AX	ADD
OD
OS