New Visit

patient

Patient Name:

Phone number:

PD of patient:

visits:

Date of visit:: 8/26/2024 7:23:00 PM
Cost:: 35
Service:: Change Lenses
prescribed by doctor:: Dr. Sadek Sadek
Notes:: Transition AR for Distance Only

	SPH	CYL	AX	ADD
OD	-1	-0.5	90	3
OS	-1.25			3

New visit Information

Date of visit:

Cost in this visit:

type of service:

prescribed by doctor

Note:

	SPH	CYL	AX	ADD
OD
OS