New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
2/29/2024 5:15:00 PM
Cost:
45
Service:
Frame + Lenses
prescribed by doctor:
Dr. Ali Hajj
Notes:
IRIS METAL + LENSES
SPH
CYL
AX
ADD
OD
-1.25
-0.5
5
OS
-1
-0.5
175
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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