New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
2/3/2024 4:17:00 PM
Cost:
110
Service:
Airlite + Transition Lenses
prescribed by doctor:
Dr. Fadi Jurdi
Notes:
AR Transition
SPH
CYL
AX
ADD
OD
1
OS
0.5
1
160
New visit Information
Date of visit:
Cost in this visit:
type of service:
prescribed by doctor
Note:
SPH
CYL
AX
ADD
OD
OS
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