New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
8/30/2024 4:18:00 PM
Cost:
300
Service:
Frame + Lenses
prescribed by doctor:
Dr. Hussein Hazimeh
Notes:
we did not follow drs prescription we did our own MR because px wasnt comfortable but we did get approval from the Dr
SPH
CYL
AX
ADD
OD
1.75
2
OS
2.75
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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