New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
9/2/2024 4:51:00 PM
Cost:
115
Service:
Frame + Lenses + Change lenses
prescribed by doctor:
Dr. Hussein Hazimeh
Notes:
Anti-Blue Transition
SPH
CYL
AX
ADD
OD
1.5
-3.75
15
OS
0.75
-2.25
145
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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