New Visit

patient

Patient Name:

Phone number:

PD of patient:

visits:

Date of visit:: 9/7/2024 5:53:00 PM
Cost:: 55
Service:
prescribed by doctor:: Dr. Fouaad Kheriess
Notes:: Took metal frame , then came back we exchanged with airlite (AB GC)

	SPH	CYL	AX	ADD
OD		-0.75	170
OS		-0.5	30

New visit Information

Date of visit:

Cost in this visit:

type of service:

prescribed by doctor

Note:

	SPH	CYL	AX	ADD
OD
OS