New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
12/16/2024 1:07:00 PM
Cost:
70
Service:
2 Frames + 2 Pair of lenses
prescribed by doctor:
Dr. Hussein Alameh
Notes:
2 Metal Frames one for Dist and one for Near
SPH
CYL
AX
ADD
OD
1.75
2.25
OS
1.5
2.5
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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