New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
2/23/2024 1:38:00 PM
Cost:
40
Service:
einar frame + ar
prescribed by doctor:
aya
Notes:
reading only
SPH
CYL
AX
ADD
OD
2
OS
2
Date of visit:
8/10/2026 3:52:00 PM
Cost:
60
Service:
2 Frame + 2 Lenses
prescribed by doctor:
Amira Lshekh
Notes:
2 pair AR
SPH
CYL
AX
ADD
OD
1.5
-0.75
70
1.5
OS
1.5
-0.5
90
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
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