New Visit

patient

Patient Name:

Phone number:

PD of patient:

visits:

Date of visit:: 9/12/2024 5:03:00 PM
Cost:: 30
Service:: Change Lenses
prescribed by doctor:: Dr. Sadek Sadek
Notes:: Anti-Blue 1.61

	SPH	CYL	AX	ADD
OD	-2	-1	180
OS	-2	-1	180

New visit Information

Date of visit:

Cost in this visit:

type of service:

prescribed by doctor

Note:

	SPH	CYL	AX	ADD
OD
OS