New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
8/21/2024 11:45:00 AM
Cost:
60
Service:
2 oliver peoples+ 2 lenses Ar
prescribed by doctor:
Dr. Jamal Haidar
Notes:
SPH
CYL
AX
ADD
OD
1
-0.5
110
2
OS
1
2
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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